LODI COMMUNITY HOSPITAL
Critical Access Hospitals
16
Procedure Prices at LODI COMMUNITY HOSPITAL
Routine Venipuncture
CPT 36415
$2.77
EKG Tracing
CPT 93005
$14.85
Cbc Auto W Auto Diff
CPT 85025
$19.72
Compre Meta Panl
CPT 80053
$26.81
Chest X-Ray (1 view)
CPT 71045
$75.33
Diagnostic Mammogram (unilateral)
CPT 77065
$101.79
Chest X-Ray (2 views)
CPT 71046
$102.87
Thoracic Spine X-Ray
CPT 72072
$104.49
Screening Mammogram (bilateral)
CPT 77067
$109.35
Diagnostic Mammogram (bilateral)
CPT 77066
$123.93
Abdominal Ultrasound — Limited
CPT 76705
$180.9
OB Ultrasound
CPT 76805
$202.23
Retroperitoneal Ultrasound
CPT 76770
$228.15
Abdominal Ultrasound
CPT 76700
$270.81
CT Chest
CPT 71250
$605.07
MRI Joint of Lower Extremity
CPT 73721
$846.72
MRI Brain w/o Contrast
CPT 70551
$1,011.96
MRI Brain w/ Contrast
CPT 70553
$1,235.25
CT Abdomen & Pelvis
CPT 74177
$1,334.07
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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.