ADVENTIST HEALTH LODI MEMORIAL
Hospital
Procedure Prices at ADVENTIST HEALTH LODI MEMORIAL
Insertion of needle into vein for collection of blood sample
CPT 36415
$1.26
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
CPT 85025
$1.9
EKG Interpretation
CPT 93010
$2.08
Blood test, comprehensive group of blood chemicals
CPT 80053
$2.61
EKG
CPT 93000
$5.6
EKG Tracing
CPT 93005
$8
Echocardiogram
CPT 93307
$12.8
Mechanical Traction
CPT 97012
$15.06
Chest X-Ray (1 view)
CPT 71045
$20.41
Upper GI Endoscopy w/ Biopsy
CPT 43239
$29.75
Thoracic Spine X-Ray
CPT 72072
$30.32
MRI Joint of Lower Extremity
CPT 73721
$35.56
Chest X-Ray (2 views)
CPT 71046
$35.68
Therapeutic Exercises
CPT 97110
$36.82
Therapeutic Activities
CPT 97530
$39.55
OB Ultrasound
CPT 76805
$51.62
Established patient office or other outpatient visit, 20-29 minutes
CPT 99213
$54.75
ER Visit — Low-Moderate Complexity
CPT 99283
$65.93
Echocardiogram w/ Doppler
CPT 93306
$68.19
Laparoscopic Hernia Repair
CPT 49650
$74.4
Colonoscopy w/ Biopsy
CPT 45380
$84.48
Inguinal Hernia Repair
CPT 49505
$90.24
Colonoscopy
CPT 45378
$105.62
Recurrent Inguinal Hernia Repair
CPT 49520
$109.6
Abdominal Ultrasound
CPT 76700
$142.74
Abdominal Ultrasound — Limited
CPT 76705
$142.74
Retroperitoneal Ultrasound
CPT 76770
$142.74
ER Visit — Moderate Complexity
CPT 99284
$145.46
CT Chest
CPT 71250
$172.94
ER Visit — High Complexity
CPT 99285
$180.57
Knee Arthroscopy
CPT 29881
$242.72
Knee Replacement
CPT 27447
$301.44
MRI Brain w/o Contrast
CPT 70551
$311.87
Treatment of broken neck of thigh bone with bone implant
CPT 27245
$347.2
VBAC Delivery
CPT 59610
$349.76
Repair of shoulder rotator cuff using an endoscope
CPT 29827
$472.8
MRI Brain w/ Contrast
CPT 70553
$492.05
CT Abdomen & Pelvis
CPT 74177
$492.05
Hip Replacement
CPT 27130
$603.04
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
CPT 64483
$742.24
Vaginal Delivery
CPT 59400
$831.52
C-Section
CPT 59510
$924.8
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$2,871.7
Laparoscopic Cholecystectomy
CPT 47562
$8,677.27
Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.