Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
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 |
|---|---|---|---|---|
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,939.92 | $7,080.00 | $39.76 – $1,590.28 | 18 |
| Dextran 40 infusion HCPCS J7100 | $37.82 | $138.00 | $12.10 – $110.00 | 13 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $21.38 | $78.00 | $1.25 – $49.80 | 17 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $16.44 | $60.00 | $1.05 – $49.80 | 13 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $142.21 | $519.00 | $1.82 – $49.80 | 17 |
| Dextrose 5 % IV bolus HCPCS J7070 | $21.38 | $78.00 | $3.64 – $49.80 | 17 |
| Diabetes (HbA1c) Test CPT 83036 | $149.06 | $544.00 | $0.55 – $21.50 | 21 |
| Diab manage trn ind/group HCPCS G0109 | $44.67 | $163.00 | $12.26 – $135.29 | 20 |
| Diag bronchoscope/catheter CPT 31643 | $1,294.38 | $4,724.00 | $167.04 – $3,920.92 | 19 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $268.73 – $9,583.66 | 12 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $94.71 – $655.48 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $124.45 – $1,936.79 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $25.21 – $211.74 | 12 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $52.33 – $365.14 | 12 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $180.84 | $660.00 | $71.55 – $547.80 | 19 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $597.60 | $2,181.00 | $190.14 – $2,181.00 | 14 |
| Dialysis one evaluation CPT 90945 | $668.84 | $2,441.00 | $82.81 – $1,843.43 | 19 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $33.43 | $122.00 | $0.08 – $0.83 | 15 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $32.61 | $119.00 | $5.50 – $41.50 | 17 |
| Dicyclomine injection HCPCS J0500 | $110.70 | $404.00 | $7.59 – $62.32 | 17 |
| Diffusing capacity CPT 94729 | $177.56 | $648.00 | $52.90 – $537.84 | 14 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $92.28 – $496.02 | 7 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $172.90 | $631.00 | $2.98 – $41.50 | 17 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $2,597.52 | $9,480.00 | $1,042.80 – $11,556.92 | 20 |
| Digoxin total therapeutic drug level CPT 80162 | $121.11 | $442.00 | $11.80 – $366.86 | 21 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $1,547.83 | $5,649.00 | $15.40 – $199.45 | 17 |
| Dilate biliary duct/ampulla CPT 47542 | $581.71 | $2,123.00 | $131.24 – $2,018.72 | 14 |
| Dilate esophagus CPT 43453 | not published | not published | $87.81 – $3,116.04 | 12 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $53.41 – $1,540.06 | 12 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $854.30 – $854.30 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $84.61 – $842.72 | 12 |
| Dilate urethra stricture CPT 53600 | not published | not published | $63.56 – $537.35 | 12 |
| Dilate urethra stricture CPT 53601 | not published | not published | $53.45 – $507.50 | 12 |
| Dilate urethra stricture CPT 53605 | not published | not published | $33.75 – $5,665.36 | 12 |
| Dilate urethra stricture CPT 53621 | not published | not published | $71.61 – $753.16 | 12 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $42.02 – $461.55 | 12 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $173.02 – $1,936.79 | 12 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $39.54 – $5,222.78 | 12 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $121.33 – $1,936.79 | 12 |
| Dilation of salivary duct CPT 42660 | not published | not published | $44.86 – $836.51 | 12 |
| Dilation of urethra CPT 53661 | not published | not published | $40.49 – $468.45 | 12 |
| Dilation of urethra CPT 53665 | not published | not published | $20.08 – $3,364.94 | 12 |
| Dilation of vagina CPT 57400 | not published | not published | $86.49 – $5,222.78 | 12 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $34.61 – $2,433.19 | 12 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $86.97 – $1,096.40 | 12 |
| Dilator fascial 10fx20cm HCPCS C2627 | $453.47 | $1,655.00 | $7.15 – $55.25 | 16 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,470.39 | $9,016.00 | $131.42 – $7,483.28 | 19 |
| Dilat xst trc new access rcs CPT 50437 | $2,470.39 | $9,016.00 | $218.91 – $7,483.28 | 19 |
| Dimecaprol injection HCPCS J0470 | $211.26 | $771.00 | $41.66 – $328.68 | 17 |
| Dimenhydrinate injection HCPCS J1240 | $13.70 | $50.00 | $4.31 – $41.50 | 14 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $13.70 | $50.00 | $0.70 – $41.50 | 17 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $75.08 | $274.00 | $21.45 – $172.17 | 16 |
| Dipyridamole injection HCPCS J1245 | $14.53 | $53.00 | $2.42 – $18.26 | 14 |
| Disability dlco CPT 94727 | $182.21 | $665.00 | $37.20 – $551.95 | 19 |
| Disaccharidases CPT 82657 | $36.17 | $132.00 | $2.17 – $49.09 | 21 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $387.06 – $3,004.74 | 12 |
| Disarticulation shoulder CPT 23920 | not published | not published | $871.11 – $4,682.19 | 7 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,379.50 – $7,414.83 | 7 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $194.17 – $1,203.30 | 7 |
| Dissect brain w/scope CPT 62161 | not published | not published | $789.51 – $2,958.44 | 7 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $786.88 – $8,879.54 | 12 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,099.69 – $6,464.10 | 7 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $677.58 – $9,717.21 | 12 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $342.48 – $2,726.34 | 7 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $247.21 – $1,063.00 | 7 |
| Dna antibody native/double stranded CPT 86225 | $3.40 | $12.39 | $1.10 – $30.42 | 21 |
| Dna gardnerella CPT 87510 | $95.36 | $348.00 | $2.01 – $44.39 | 21 |
| Dna probe gc CPT 87590 | $2.20 | $8.00 | $0.88 – $59.52 | 21 |
| Dna trichomonas CPT 87660 | $103.03 | $376.00 | $2.01 – $44.39 | 21 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $94.53 | $345.00 | $5.50 – $41.50 | 17 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $20.28 | $74.00 | $0.61 – $14.11 | 17 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $25.49 | $93.00 | $0.55 – $41.50 | 17 |
| Doppler echo complete CPT 93320 | $353.46 | $1,290.00 | $36.45 – $1,070.70 | 14 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $1,595.78 | $5,824.00 | $278.63 – $4,833.92 | 14 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $463.06 | $1,690.00 | $111.72 – $1,402.70 | 20 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $315.10 | $1,150.00 | $59.79 – $677.28 | 20 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | $50.42 | $184.00 | $0.86 – $43.99 | 17 |
| Dornhoffer fixed part w/window HCPCS L8614 | $47,681.48 | $174,020.00 | $237.05 – $1,831.75 | 16 |
| Dorsi & plantar flex ass/res HCPCS L2220 | $157.55 | $575.00 | $63.25 – $488.75 | 17 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $13,638.08 | $49,774.00 | $5,475.14 – $49,774.00 | 9 |
| Double transfer toe-hand CPT 26554 | not published | not published | $3,266.54 – $17,557.66 | 7 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $338.12 | $1,234.00 | $3.15 – $52.29 | 17 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $4,106.72 | $14,988.00 | $135.42 – $6,709.72 | 20 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $3,177.58 | $11,597.00 | $5.83 – $53.00 | 9 |
| Dpyd gene common variants CPT 81232 | $66.31 | $242.00 | $26.62 – $387.14 | 21 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $56.83 – $1,155.74 | 12 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $67.50 – $1,155.74 | 12 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $131.74 – $2,661.45 | 12 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $64.94 – $1,155.74 | 12 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $107.66 – $4,701.27 | 12 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $306.89 – $4,701.27 | 12 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $66.65 – $381.45 | 12 |
| Drainage of abdomen CPT 48000 | not published | not published | $628.88 – $3,380.21 | 7 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $130.73 – $2,661.45 | 12 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $387.06 – $4,701.27 | 12 |
| Drainage of bone lesion CPT 26992 | not published | not published | $1,036.14 – $5,986.52 | 7 |
| Drainage of bone lesion CPT 27303 | not published | not published | $668.83 – $4,261.97 | 7 |
| Drainage of eye CPT 65800 | not published | not published | $90.15 – $3,746.39 | 12 |
| Drainage of eye CPT 65810 | not published | not published | $387.06 – $3,746.39 | 12 |
| Drainage of eye CPT 65815 | not published | not published | $261.46 – $3,746.39 | 12 |
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.