Knee arthroscopy at Lodi Memorial Hospital Association. CPT 29881.
What Lodi Memorial Hospital Association publishes for this service, straight from its standard-charges file, last updated August 2, 2026.
Outpatient / ER
$15.61cash price (self-pay)
$390list price
$70.00–$16,622range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bc Mcal | Bc Mcal | $70.00 |
| Celtic Ins Company - All Plans | Celtic Ins Company - All Plans | $70.00 |
| Kaiser Mcal | Kaiser Mcal | $70.00 |
| Medi-Cal | Medi-Cal | $70.00 |
| Hp Mcal Pro Fee | Hp Mcal Pro Fee | $77.00 |
| Healthnet Mcal | Healthnet Mcal | $84.00 |
| Hp Of San Joaquin Mcal | Hp Of San Joaquin Mcal | $84.00 |
| Medcore(Omni Ipa) Op Only- All Plans | Medcore(Omni Ipa) Op Only- All | $497 |
| Alignment Health Plan (Ahp)-All Plans | Alignment Health Plan (Ahp)-Al | $521 |
| Blue Shield Mcare Adv | Blue Shield Mcare Adv | $521 |
| Healthnet Mcare | Healthnet Mcare | $521 |
| Hp Of San Joaquin Mcr Adv | Hp Of San Joaquin Mcr Adv | $521 |
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $521 |
| Knnex Health - All Plans | Knnex Health - All Plans | $521 |
| Tricare Blue Shield - All Plans | Tricare Blue Shield - All Plans | $521 |
| UHC Mcr Adv | UHC Mcr Adv | $521 |
| Hp Healthy Kids Pro Fee | Hp Healthy Kids Pro Fee | $547 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $573 |
| Cigna- All Plans | Cigna- All Plans | $622 |
| First Health- All Plans | First Health- All Plans | $625 |
| Beech Street- All Plans | Beech Street- All Plans | $677 |
| Hp Of San Joaquin PPO - All Other Plans | Hp Of San Joaquin PPO - All | $677 |
| Multiplan- All Plans | Multiplan- All Plans | $677 |
| Kaiser Commercial - All Other Plans | Kaiser Commercial - All Other Pl | $703 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $703 |
| Networks By Design- All Plans | Networks By Design- All Plans | $703 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $724 |
| UHC HMO | UHC HMO | $724 |
| UHC Jll | UHC Jll | $724 |
| Western Growers- All Plans | Western Growers- All Plans | $745 |
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