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 |
|---|---|---|---|---|
| Ghs plngl fx pm cl CPT 26725 | not published | not published | $155.51 – $835.88 | 12 |
| Ghs ppd (tb intradermal) CPT 86580 | $16.17 | $59.00 | $3.36 – $48.97 | 20 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $2.89 | $10.52 | $1.16 – $21.40 | 21 |
| Ghs protein, misc fluid CPT 84160 | $4.09 | $14.90 | $0.59 – $12.44 | 21 |
| Ghs protoporphyrins fract CPT 84202 | $4.39 | $16.00 | $1.72 – $31.79 | 21 |
| Ghs pr without cont pulse ox CPT 94625 | $168.79 | $616.00 | $67.76 – $511.28 | 8 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $3.01 | $10.96 | $1.21 – $27.12 | 21 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $64.51 – $346.76 | 12 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $129.91 – $916.24 | 12 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $342.63 – $2,628.88 | 12 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $373.39 – $5,329.67 | 12 |
| Ghs reticulocyte count CPT 85044 | $12.33 | $45.00 | $2.64 – $37.35 | 21 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $92.34 | $337.00 | $2.92 – $279.71 | 21 |
| Ghs sedimentation rate CPT 85651 | $121.66 | $444.00 | $2.37 – $368.52 | 21 |
| Ghs semen analysis fert CPT 89320 | $53.43 | $195.00 | $11.61 – $161.85 | 18 |
| Ghs sensitivity (per antimicro) CPT 87184 | $23.02 | $84.00 | $0.67 – $16.56 | 21 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $90.15 – $656.27 | 12 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $121.29 – $962.13 | 12 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $111.43 – $849.63 | 12 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $146.54 – $2,009.26 | 12 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $71.03 – $571.77 | 12 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $70.81 – $518.97 | 12 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $89.55 – $695.80 | 12 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $139.09 – $1,736.02 | 12 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $165.72 – $2,344.55 | 12 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $609.93 | $2,226.00 | $244.86 – $1,847.58 | 19 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $69.63 – $484.89 | 12 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $18.09 – $220.44 | 12 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $195.06 – $1,056.32 | 12 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $144.40 – $776.17 | 12 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,376.31 | $5,023.00 | $122.19 – $3,970.72 | 19 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $146.96 – $789.93 | 12 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $171.86 – $923.77 | 12 |
| Ghs urine, hydroxproline total CPT 83505 | $7.37 | $26.87 | $2.96 – $53.83 | 21 |
| Ghs urine, porphyrins quant CPT 84120 | $6.58 | $24.00 | $2.64 – $32.57 | 21 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $765.92 – $5,222.78 | 12 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $583.35 | $2,129.00 | $234.19 – $2,129.00 | 19 |
| Ghs windowing of cast CPT 29730 | not published | not published | $32.46 – $259.19 | 12 |
| Gi inhouse confirmation CPT 87045 | $35.62 | $130.00 | $7.85 – $107.90 | 21 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $197.37 – $5,327.15 | 12 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,637.43 | $5,976.00 | $657.36 – $4,960.08 | 19 |
| Gi wireless capsule measure CPT 91112 | $576.50 | $2,104.00 | $231.44 – $2,104.00 | 19 |
| Glassia injection HCPCS J0257 | $569.92 | $2,080.00 | $5.45 – $1,726.40 | 20 |
| Glaucoma surgery CPT 66150 | not published | not published | $580.60 – $6,608.05 | 12 |
| Glaucoma surgery CPT 66155 | not published | not published | $580.60 – $6,608.05 | 12 |
| Glaucoma surgery CPT 66160 | not published | not published | $580.60 – $3,746.39 | 12 |
| Glaucoma surgery CPT 66170 | not published | not published | $774.13 – $4,160.94 | 12 |
| Glove finger flexion right lg xl HCPCS L3912 | $66.59 | $243.00 | $26.73 – $206.55 | 17 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $369.36 | $1,348.00 | $21.12 – $443.71 | 20 |
| Glucagon plasma - sendout CPT 82943 | $5.48 | $19.98 | $2.20 – $31.65 | 21 |
| Glucose 1 hr post dose CPT 82950 | $40.83 | $149.00 | $4.19 – $123.67 | 21 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $27.13 | $99.00 | $5.38 – $82.17 | 21 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $47.13 | $172.00 | $2.00 – $142.76 | 21 |
| Glucose blood quantitative CPT 82947 | $35.08 | $128.00 | $2.93 – $22.08 | 21 |
| Glucose body fluid CPT 82945 | $41.38 | $151.00 | $0.39 – $8.69 | 21 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $36.17 | $132.00 | $11.27 – $109.56 | 21 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $12.88 | $47.00 | $3.46 – $39.01 | 21 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $75.35 | $275.00 | $5.50 – $50.00 | 9 |
| Gold sodium thiomaleate inj HCPCS J1600 | $37.54 | $137.00 | $15.07 – $113.71 | 16 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $2,391.75 | $8,729.00 | $10.77 – $7,245.07 | 20 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $2.74 | $10.00 | $1.01 – $41.16 | 21 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $2.50 | $9.12 | $0.91 – $41.02 | 21 |
| Goniotomy CPT 65820 | not published | not published | $484.05 – $6,608.05 | 12 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,506.56 | $9,148.00 | $206.80 – $1,640.16 | 20 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $2,859.19 | $10,435.00 | $30.36 – $6,821.25 | 17 |
| Graft axiofill 1000mg HCPCS J3590 | $3,718.18 | $13,570.00 | $399.96 – $3,636.00 | 12 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,300.13 | $4,745.00 | $67.44 – $1,406.75 | 17 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $645.54 – $5,329.67 | 12 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $24,469.57 | $89,305.00 | $25.78 – $637.50 | 17 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $2,859.19 | $10,435.00 | $311.36 – $8,869.75 | 17 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $18,384.03 | $67,095.00 | $28.05 – $216.75 | 16 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $16,712.63 | $60,995.00 | $21.45 – $165.75 | 16 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $13,812.34 | $50,410.00 | $39.06 – $2,384.25 | 17 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $8,172.05 | $29,825.00 | $103.77 – $1,831.75 | 17 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $965.52 – $5,189.69 | 7 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $13,812.34 | $50,410.00 | $134.06 – $4,033.25 | 17 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $35,824.13 | $130,745.00 | $71.36 – $4,033.25 | 16 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $4,834.73 | $17,645.00 | $39.75 – $5,244.50 | 17 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $24,469.57 | $89,305.00 | $12.65 – $97.75 | 16 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $1,690.58 | $6,170.00 | $28.05 – $216.75 | 16 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,827.35 – $15,197.01 | 7 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $75.62 – $406.47 | 12 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $518.61 – $3,004.74 | 12 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $513.77 – $6,013.60 | 12 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $148.03 – $686.80 | 7 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $424.05 – $6,013.60 | 12 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,094.11 – $5,880.87 | 7 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $907.42 – $4,877.41 | 7 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,197.51 – $6,436.59 | 7 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,167.60 – $6,275.86 | 7 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,162.58 – $4,999.10 | 7 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $555.39 – $3,116.04 | 12 |
| G-tube reposition CPT 43761 | $155.36 | $567.00 | $59.95 – $489.12 | 19 |
| Gu dilat ureter/urethra s&i CPT 74485 | $875.98 | $3,197.00 | $88.43 – $7,234.63 | 20 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,037.37 | $3,786.00 | $132.75 – $3,017.05 | 19 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $22,244.69 | $81,185.00 | $4.95 – $38.25 | 16 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $2,198.85 | $8,025.00 | $7.15 – $55.25 | 16 |
| Gum graft CPT 41870 | not published | not published | $1,835.60 – $2,433.19 | 8 |
| Gw stiffened micro access kit HCPCS C1894 | $6,285.56 | $22,940.00 | $4.95 – $38.25 | 16 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $449.66 – $6,290.08 | 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.