Mercy Gilbert Medical Center
3555 S Val Vista Dr, Gilbert, AZ · CommonSpirit Health · · NPI 1992735088
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $1,133.57 | $4,608.00 | $148.67 – $3,548.16 | 11 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $23.62 | $96.00 | $0.05 – $41.58 | 8 |
| Levetiracetam therapeutic drug level CPT 80177 | $13.04 | $53.00 | $7.42 – $40.81 | 10 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $86.10 | $350.00 | $1.28 – $143.99 | 8 |
| Liberta rc ipg HCPCS C1820 | $70,794.62 | $287,783.00 | $1,721.58 – $12,297.00 | 7 |
| Lidocaine injection HCPCS J2001 | $11.81 | $48.00 | $0.29 – $36.96 | 5 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $22.39 | $91.00 | $7.56 – $41.58 | 4 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $86.10 | $350.00 | $49.00 – $269.50 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $97.42 | $396.00 | $14.69 – $304.92 | 10 |
| Ligate esophagus veins CPT 43400 | not published | not published | $1,586.39 – $7,291.55 | 3 |
| Ligate leg veins open CPT 37761 | not published | not published | $552.88 – $3,354.67 | 9 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $590.78 – $3,354.67 | 9 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $78.68 – $3,647.53 | 3 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $1,506.64 – $7,291.55 | 3 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $473.84 – $3,354.67 | 9 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $403.75 – $3,354.67 | 9 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $392.31 – $3,388.81 | 9 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $213.14 – $1,726.88 | 9 |
| Ligation common iliac vein CPT 37660 | not published | not published | $1,366.10 – $7,291.55 | 3 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $252.48 – $3,354.67 | 9 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $781.04 – $3,354.67 | 9 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $754.21 – $3,354.67 | 9 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $757.79 – $3,354.67 | 9 |
| Ligation major artery chest CPT 37616 | not published | not published | $1,165.12 – $7,291.55 | 3 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $408.04 – $7,291.55 | 3 |
| Ligation major artery neck CPT 37615 | not published | not published | $538.93 – $3,354.67 | 9 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $638.70 – $3,354.67 | 9 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $1,368.24 – $7,291.55 | 3 |
| Ligation of femoral vein CPT 37650 | not published | not published | $471.34 – $3,354.67 | 9 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,789.52 – $5,761.50 | 9 |
| Ligation of neck artery CPT 37606 | not published | not published | $772.45 – $3,354.67 | 9 |
| Ligation of salivary duct CPT 42665 | not published | not published | $231.38 – $3,456.53 | 9 |
| Ligation of shunt CPT 49428 | not published | not published | $450.60 – $7,291.55 | 3 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $921.22 – $3,354.67 | 9 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $263.56 – $3,354.67 | 9 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $385.15 – $3,354.67 | 9 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $596.86 – $3,354.67 | 9 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $222.44 – $1,391.54 | 3 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $87.83 | $357.00 | $3.05 – $274.89 | 8 |
| Lipase CPT 83690 | $179.58 | $730.00 | $6.89 – $562.10 | 10 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $369.78 – $3,456.53 | 9 |
| Lipoprotein blood quant CPT 83704 | $33.65 | $136.76 | $19.15 – $105.31 | 10 |
| Lipoprotein direct measurement hdl CPT 83718 | $40.59 | $165.00 | $8.19 – $127.05 | 10 |
| Lipoprotein direct measurement ldl CPT 83721 | $10.34 | $42.00 | $5.88 – $32.34 | 10 |
| Lip surgery procedure CPT 40799 | not published | not published | $157.25 – $247.50 | 9 |
| Lithium therapeutic drug level CPT 80178 | $149.33 | $607.00 | $3.36 – $18.48 | 10 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,829.25 | $11,501.00 | $1,610.14 – $8,855.77 | 5 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,266.32 – $7,291.55 | 3 |
| Liver Function Test CPT 80076 | $110.21 | $448.00 | $8.17 – $344.96 | 10 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,511.29 – $7,291.55 | 3 |
| Liver imaging CPT 78201 | $1,282.89 | $5,215.00 | $184.89 – $4,015.55 | 10 |
| Liver imag w/vasclr flow CPT 78202 | $692.74 | $2,816.00 | $203.48 – $2,168.32 | 10 |
| Liver/spleen imag static only CPT 78215 | $448.95 | $1,825.00 | $190.61 – $1,405.25 | 10 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $496.01 – $3,458.17 | 9 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $13.29 | $54.00 | $1.38 – $36.96 | 8 |
| Low back disk surgery CPT 63030 | not published | not published | $964.85 – $7,613.93 | 9 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,778.83 | $7,231.00 | $189.74 – $5,567.87 | 11 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,400.24 | $5,692.00 | $182.03 – $4,382.84 | 11 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,147.59 | $4,665.00 | $113.34 – $3,592.05 | 11 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,193.34 | $8,916.00 | $344.74 – $6,865.32 | 11 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,162.35 | $4,725.00 | $292.17 – $3,638.25 | 11 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $833.45 | $3,388.00 | $206.70 – $2,608.76 | 11 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $230.01 | $935.00 | $41.84 – $287.98 | 10 |
| Lower jaw bone graft CPT 21215 | not published | not published | $829.67 – $6,305.03 | 9 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $771.02 – $11,096.49 | 9 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $888.32 – $11,096.49 | 9 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $875.09 – $11,096.49 | 9 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $954.48 – $11,096.49 | 9 |
| Lumbar diskogram s&i CPT 72295 | $669.12 | $2,720.00 | $116.94 – $2,094.40 | 10 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,658.27 – $19,600.48 | 9 |
| Lung Function Test (Spirometry) CPT 94010 | $103.57 | $421.00 | $28.61 – $324.17 | 10 |
| Lung perfusion imaging CPT 78580 | $456.83 | $1,857.00 | $227.09 – $1,429.89 | 10 |
| Lung transplant double CPT 32853 | not published | not published | $4,681.21 – $7,291.55 | 3 |
| Lung transplant single CPT 32851 | not published | not published | $3,351.23 – $7,291.55 | 3 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,609.79 – $7,291.55 | 3 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,956.21 – $7,291.55 | 3 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,517.01 – $7,291.55 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $26.10 – $26.76 | 9 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $743.13 – $7,291.55 | 3 |
| Lymphatics/lymph node imaging CPT 78195 | $1,141.20 | $4,639.00 | $339.02 – $3,572.03 | 10 |
| Lymphocyte transformation mitogen CPT 86353 | $49.20 | $200.00 | $27.46 – $151.02 | 10 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $159.85 – $542.77 | 9 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $164.50 – $3,388.81 | 9 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $210.99 – $2,183.34 | 9 |
| Macroscopic exam arthropod CPT 87168 | $72.57 | $295.00 | $4.27 – $227.15 | 10 |
| Macroscopic exam parasite CPT 87169 | $18.95 | $77.00 | $4.31 – $54.34 | 10 |
| Magnesium CPT 83735 | $72.57 | $295.00 | $3.76 – $20.64 | 10 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $86.10 | $350.00 | $0.50 – $36.96 | 8 |
| Male sling procedure CPT 53440 | not published | not published | $789.26 – $13,847.58 | 9 |
| Mammosite ced HCPCS C1728 | $6,652.34 | $27,042.00 | $41.86 – $299.00 | 7 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $3,120.21 – $7,291.55 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $385.51 – $1,705.75 | 9 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $466.33 – $1,705.75 | 9 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $73.80 | $300.00 | $41.13 – $231.00 | 10 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $80.45 | $327.00 | $26.11 – $251.79 | 10 |
| Manipulation of hip joint CPT 27275 | not published | not published | $195.62 – $1,705.75 | 9 |
| Manipulation of spine CPT 22505 | not published | not published | $136.97 – $1,705.75 | 9 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $82.97 – $255.67 | 9 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $86.10 | $350.00 | $2.60 – $36.96 | 8 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $142.33 – $1,215.84 | 3 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.