How many shoppable procedure prices are published for Adventist Health Lodi Memorial?

Adventist Health Lodi Memorial in Lodi, CA currently has 122 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Adventist Health Lodi Memorial's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Adventist Health Lodi Memorial's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

What is Adventist Health Lodi Memorial's CMS Care Compare overall star rating?

CMS Care Compare assigns Adventist Health Lodi Memorial an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Other 186 Beds · urban Updated: 2026-08-02

Adventist Health Lodi Memorial

975 S Fairmont Avenue, Lodi, CA 95240 · 122 Priced Procedures · 68% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.80×vs. Fair Market Price

Typical commercial prices here are 20% below the fair benchmark (0.80×) after accounting for local nurse/doctor wages and patient complexity.

74/100 · Corroborated

74/100Self-Pay Cash Beats Insurance 80% of the Time

File Completeness45

Price Logic72

Peer Alignment68

Clean Billing93

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 0.80× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Adventist Health Lodi Memorial maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.91× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.99× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#10 of 240 in CA · 3rd State Percentile#266 of 3,385 in U.S. · 7th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 20% below peer Fair BaseRate (0.80×)
Self-pay cash beats commercial insurance on 80% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (66/100 safety score) with 68% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (21.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.80× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (2.0×) & laboratory (1.2×) services average 1.25× higher multiples than routine shoppable care (0.8×)
Specialty infusion drugs (J-codes) average 1.3× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 8.8× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.8× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.25× Divergence

1.0× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+9% Upper Tail

Q25 0.46× · Q50 0.91× · Q75 0.99×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.3× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

2.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.3× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

80% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 66/100Fair

Procedure Prices at Adventist Health Lodi Memorial

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 122 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$11,754	$19,294	$19,087	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$13,612	$19,159	$19,432	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$10,508	$17,511	$17,936	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$6,343	$7,821	$8,223	1.0×
Blood transfusion CPT Code: `36430`	$267	$3,068	$498	unverified
C-section delivery (full package) CPT Code: `59510`	$541	$2,542	$2,975	0.9×
Vaginal delivery (full package) CPT Code: `59400`	$491	$2,351	$2,680	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$61	$772	$3,372	0.2×
Cataract surgery with lens implant CPT Code: `66984`	$133	$597	$2,540	0.2×
Bunion correction surgery CPT Code: `28296`	$128	$597	$3,446	0.2×
Inguinal hernia repair CPT Code: `49505`	$55	$593	$3,629	0.2×
Breast lump removal CPT Code: `19120`	$110	$557	$3,875	0.1×
Colonoscopy with biopsy CPT Code: `45380`	$65	$378	$1,256	0.3×
Rabies immune globulin HCPCS Code: `90375`	$198	$337	$322	1.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$41	$347	$981	0.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$566	$311	$511	0.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$477	$282	$448	0.6×
Sleep study (overnight, in lab) CPT Code: `95810`	$71	$295	$1,021	0.3×
Behavioral health assessment HCPCS Code: `H0001`	$18	$250	$157	1.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$30	$268	$583	0.5×
Upper endoscopy with biopsy CPT Code: `43239`	$29	$262	$987	0.3×
MRI, brain (no contrast) CPT Code: `70551`	$519	$219	$343	0.6×
Psychiatric evaluation (first visit) CPT Code: `90791`	$28	$192	$185	1.0×
MRI, knee or other leg joint CPT Code: `73721`	$26	$207	$369	0.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	$26	$179	$181	1.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$312	$168	$258	0.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$290	$174	$303	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$382	$186	$338	0.6×
Care planning with family CPT Code: `90887`	$10	$140	$107	1.3×
Hepatitis B immune globulin HCPCS Code: `90371`	$114	$151	$151	1.0×
Family therapy session CPT Code: `90847`	$18	$152	$173	0.9×
Review of medical records for care CPT Code: `90889`	$9	$123	$114	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$169	$127	$167	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$17	$124	$166	0.7×
CT scan, sinuses CPT Code: `70486`	$214	$123	$166	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$165	$125	$169	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$165	$124	$168	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$285	$143	$242	0.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$123	$125	$272	0.5×
Prosthetic fitting and training CPT Code: `97761`	$23	$86	$45	1.9×
Speech therapy (language evaluation) CPT Code: `92507`	$45	$96	$86	1.1×
New patient office visit (30-44 min) CPT Code: `99203`	$16	$96	$110	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$18	$103	$123	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$165	$101	$160	0.6×
CT scan, pelvis CPT Code: `72192`	$90	$101	$163	0.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$79	$83	$134	0.6×
Neurobehavioral status check CPT Code: `96116`	$15	$104	$231	0.5×
Typhoid vaccine HCPCS Code: `90675`	$89	$393	$347	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$10	$123	$111	1.1×
Flu vaccine (high dose) HCPCS Code: `90656`	$6	$65	$25	2.6×
Hepatitis B vaccine HCPCS Code: `90744`	$5	$63	$37	1.7×
Extended office visit (prolonged) HCPCS Code: `G2212`	$5	$52	$33	1.6×
Orthotic fitting and training CPT Code: `97760`	$9	$68	$51	1.3×
Speech therapy (group session) CPT Code: `92508`	$33	$37	$27	1.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$5	$53	$39	1.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$7	$74	$56	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$13	$69	$87	0.8×
Ultrasound, pelvis CPT Code: `76856`	$72	$68	$130	0.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$86	$61	$126	0.5×
Ultrasound, thyroid and neck CPT Code: `76536`	$79	$60	$132	0.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$13	$64	$148	0.4×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$4	$28	$25	1.1×
Diagnostic procedure preparation HCPCS Code: `G0279`	$5	$38	$35	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$12	$35	$34	1.0×
Blood test, vitamin D CPT Code: `82306`	$14	$30	$31	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$7	$51	$123	0.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$11	$14	$14	1.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$15	$36	$38	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$15	$36	$38	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$12	$36	$38	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$12	$13	$14	0.9×
X-ray, hip CPT Code: `73502`	$71	$37	$93	0.4×
X-ray, lower back CPT Code: `72110`	$103	$44	$112	0.4×
Psychological testing evaluation CPT Code: `96136`	$6	$44	$128	0.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$15	$12	$11	1.1×
Blood test, liver function panel CPT Code: `80076`	$6	$9	$9	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$5	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$4	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$4	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$6	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$3	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$1	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$2	$3	$3	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$5	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$2	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$5	$9	$9	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$18	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$20	$17	$18	0.9×
Physical therapy (gait training) CPT Code: `97116`	$15	$31	$33	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$11	$8	$9	0.9×
X-ray, shoulder CPT Code: `73030`	$17	$31	$92	0.3×
Blood test, calcium CPT Code: `82310`	$4	$5	$5	1.0×
X-ray, hand CPT Code: `73130`	$38	$30	$93	0.3×
X-ray, ankle CPT Code: `73610`	$24	$30	$93	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$10	$3	$3	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$6	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$1	$4	$4	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$21	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	—	$14	$15	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$26	$37	$40	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$15	$32	$35	0.9×
Blood test, amylase CPT Code: `82150`	$4	$6	$7	0.9×
X-ray, chest (two views) CPT Code: `71046`	$35	$27	$93	0.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$33	$26	$93	0.3×
X-ray, foot CPT Code: `73630`	$23	$25	$92	0.3×
X-ray, pelvis CPT Code: `72170`	$21	$22	$110	0.2×
X-ray, chest (single view) CPT Code: `71045`	$14	$18	$92	0.2×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$25	$25	$6,109	0.0×
Total hip replacement CPT Code: `27130`	$49	$49	$13,413	0.0×
Total knee replacement CPT Code: `27447`	$46	$46	$13,523	0.0×
Culture, blood CPT Code: `87040`	$6	$10	$11	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$4	$4	$5	0.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$15	$15	$20	0.8×
Group therapy session CPT Code: `90853`	$5	$29	$100	0.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$8	$17	$64	0.3×
Blood antibody screen CPT Code: `86850`	$7	$10	$46	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$7	$19	$201	0.1×
Colorectal cancer screening HCPCS Code: `G0010`	$4	$4	$49	0.1×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$16	$16	$203	0.1×
Pneumococcal vaccine HCPCS Code: `90732`	$8	$8	$140	0.1×
Electrical stimulation therapy HCPCS Code: `G0283`	$5	$5	$14	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$28	$28	$86	unverified

Showing top 25 high-impact procedures of 122 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 21.8%

Audit a Bill or Quote at Adventist Health Lodi Memorial (Zero PHI Required)

CMS CCN: 050336

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $11,754

Insurer Median $19,294

1. Amount on Your Bill or Quote ($) Pre-filled with Adventist Health Lodi Memorial’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $36,656 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $36,656

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (21.8% of gross = $36,656).

Step 2 · Cash vs. Insurance Arbitrage Save $156,164 Paying Cash

Self-Pay Cash Rate ($11,754) Beats Your Bill

Adventist Health Lodi Memorial's published 45 CFR § 180 self-pay cash rate is $11,754 (vs. $19,294 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$148,831 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($167,918) is $148,831 above the denoised Fair BaseRate ($19,087) and 11.9× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (21.8% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend68%

Rated 9 or 10 (HCAHPS)69%

Median ER Wait193 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Adventist Health Lodi Memorial. Prior administrative notices do not necessarily reflect current compliance status.

2025-08-27·administrative_or_closure
Met Requirements
Recorded
2024-03-05·administrative_or_closure
Met Requirements
Recorded
2023-01-10·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (426 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Adventist Health Lodi Memorial.

Price Index: 0.65× regional baseline

Quality: 61/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

-45.2%

Bright Health

+92.5%

Median Household Income$88,531U.S. Census ACS

Local Uninsured Share6.4%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 74/100 · Corroborated CMS CCN 050336

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 050336) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-08-02 · 507.14 MB

Validated Rate Rows10,507 (CMS v3.0.0)

File Integrity DigestVerified · CCN 050336

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy