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 |
|---|---|---|---|---|
| Wedge rescj/bisctj ovary uni/bi 58920 CPT 58920 | not published | not published | $718.22 – $12,146.90 | 12 |
| Wedge resect of lung add-on 32506 CPT 32506 | not published | not published | $127.33 – $547.52 | 7 |
| Wedge resect of lung diag 32507 CPT 32507 | not published | not published | $127.33 – $547.52 | 7 |
| Wedge resect of lung initial 32505 CPT 32505 | not published | not published | $770.66 – $3,313.84 | 7 |
| Wedging of cast CPT 29740 | not published | not published | $68.74 – $450.07 | 12 |
| Wedging of clubfoot cast CPT 29750 | not published | not published | $71.34 – $436.25 | 12 |
| Wet mounts/ w preparations HCPCS Q0111 | $36.99 | $135.00 | $3.66 – $112.05 | 21 |
| Whfo nontorsion joint prefab HCPCS L3931 | $82.20 | $300.00 | $33.00 – $255.00 | 17 |
| Whfo w/joint(s) custom fab HCPCS L3806 | $205.50 | $750.00 | $82.50 – $637.50 | 17 |
| Whole blood for transfusion HCPCS P9010 | $154.81 | $565.00 | $62.15 – $565.00 | 19 |
| Who nontorsion jnts pre cst HCPCS L3915 | $20.83 | $76.00 | $8.36 – $76.00 | 17 |
| Wnd prep f/n/hf/g addl cm CPT 15005 | not published | not published | $87.34 – $430.65 | 7 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $377.30 | $1,377.00 | $20.98 – $487.50 | 16 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $377.30 | $1,377.00 | $23.94 – $656.27 | 16 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $374.29 | $1,366.00 | $24.93 – $526.22 | 16 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $427.72 | $1,561.00 | $26.98 – $1,088.96 | 16 |
| Wrist arthroscopy CPT 29840 | not published | not published | $306.74 – $5,329.67 | 12 |
| Wrist arthroscopy/surgery CPT 29843 | not published | not published | $417.40 – $5,329.67 | 12 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $430.22 – $5,329.67 | 12 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $522.92 – $5,329.67 | 12 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $550.33 – $5,329.67 | 12 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $495.15 – $11,734.48 | 12 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $287.52 – $2,628.88 | 12 |
| Xcapsl ctrc rmvl cplx w/ecp CPT 66987 | not published | not published | $873.45 – $6,608.05 | 8 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $770.32 – $4,338.40 | 12 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $823.92 – $6,608.05 | 8 |
| Xcellistem, 1 mg HCPCS A2004 | $2,859.19 | $10,435.00 | $308.55 – $2,384.25 | 16 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $387.06 – $3,004.74 | 12 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $1,793.06 | $6,544.00 | $290.51 – $5,431.52 | 19 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $315.71 – $1,357.55 | 7 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $188.77 – $1,370.37 | 7 |
| X-ray abdomen 1 view CPT 74018 | $288.80 | $1,054.00 | $23.74 – $874.82 | 20 |
| X-ray abdomen 2 views CPT 74019 | $320.58 | $1,170.00 | $28.97 – $971.10 | 20 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $320.58 | $1,170.00 | $38.70 – $971.10 | 20 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $303.32 | $1,107.00 | $22.24 – $918.81 | 20 |
| X-ray bone length studies CPT 77073 | $338.12 | $1,234.00 | $32.05 – $1,024.22 | 20 |
| X-ray bone survey complete CPT 77075 | $370.18 | $1,351.00 | $78.50 – $1,121.33 | 20 |
| X-ray bone survey infant CPT 77076 | $370.18 | $1,351.00 | $63.60 – $1,121.33 | 20 |
| X-ray cervical spine 2-3 views CPT 72040 | $288.80 | $1,054.00 | $32.34 – $874.82 | 20 |
| X-ray cervical spine 4-5 views CPT 72050 | $320.58 | $1,170.00 | $45.80 – $971.10 | 20 |
| X-ray cervical spine >= 6 views CPT 72052 | $320.58 | $1,170.00 | $53.28 – $971.10 | 20 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $462.79 | $1,689.00 | $74.46 – $1,401.87 | 20 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $462.79 | $1,689.00 | $90.14 – $1,401.87 | 20 |
| Xray endovasc thor ao repr CPT 75956 | $2,836.73 | $10,353.00 | $326.19 – $8,592.99 | 15 |
| Xray endovasc thor ao repr CPT 75957 | $3,177.03 | $11,595.00 | $279.43 – $9,623.85 | 15 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $477.31 | $1,742.00 | $54.64 – $1,445.86 | 20 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $321.13 | $1,172.00 | $61.12 – $972.76 | 20 |
| X-ray exam of eye sockets CPT 70200 | $355.11 | $1,296.00 | $38.32 – $1,075.68 | 20 |
| X-ray exam of sinuses CPT 70210 | $303.32 | $1,107.00 | $26.73 – $918.81 | 20 |
| X-ray exam thorac spine4/>vw CPT 72074 | $321.95 | $1,175.00 | $36.83 – $975.25 | 20 |
| X-ray facial bones complete > 3 views CPT 70150 | $291.54 | $1,064.00 | $38.32 – $883.12 | 20 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $320.58 | $1,170.00 | $34.21 – $971.10 | 20 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $320.58 | $1,170.00 | $43.85 – $971.10 | 20 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $320.58 | $1,170.00 | $51.04 – $971.10 | 20 |
| X-ray knee ap standing bilateral CPT 73565 | $306.06 | $1,117.00 | $27.28 – $927.11 | 20 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $321.95 | $1,175.00 | $33.46 – $975.25 | 20 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $321.95 | $1,175.00 | $43.93 – $975.25 | 20 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $321.95 | $1,175.00 | $52.16 – $975.25 | 20 |
| X-ray mandible complete > 4 views CPT 70110 | $352.64 | $1,287.00 | $35.33 – $1,068.21 | 20 |
| X-ray mandible ltd <4 views CPT 70100 | $317.30 | $1,158.00 | $33.46 – $961.14 | 20 |
| X-ray nasal bones complete > 3 views CPT 70160 | $317.57 | $1,159.00 | $32.71 – $961.97 | 20 |
| X-ray neck soft tissue CPT 70360 | $288.80 | $1,054.00 | $24.82 – $874.82 | 20 |
| X-ray nose to rectum for foreign body child CPT 76010 | $288.80 | $1,054.00 | $22.99 – $874.82 | 20 |
| X-ray pelvis 1-2 views CPT 72170 | $321.95 | $1,175.00 | $21.87 – $975.25 | 20 |
| X-ray pelvis complete > 3 views CPT 72190 | $321.95 | $1,175.00 | $33.46 – $975.25 | 20 |
| Xray place dist ext thor ao CPT 75959 | $902.01 | $3,292.00 | $163.19 – $2,732.36 | 15 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $762.55 | $2,783.00 | $60.01 – $2,309.89 | 20 |
| X-ray ribs 3 views bilateral CPT 71110 | $321.95 | $1,175.00 | $33.46 – $975.25 | 20 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $321.95 | $1,175.00 | $41.31 – $975.25 | 20 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $320.58 | $1,170.00 | $31.96 – $971.10 | 20 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $288.80 | $1,054.00 | $27.10 – $874.82 | 20 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $303.32 | $1,107.00 | $30.47 – $918.81 | 20 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $647.47 | $2,363.00 | $39.44 – $1,961.29 | 20 |
| X-ray skull < 4 views CPT 70250 | $321.95 | $1,175.00 | $30.47 – $975.25 | 20 |
| X-ray skull > 4 views complete CPT 70260 | $321.95 | $1,175.00 | $34.96 – $975.25 | 20 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $524.99 | $1,916.00 | $91.79 – $1,590.28 | 20 |
| X-ray small intestine follow-through study CPT 74248 | $629.93 | $2,299.00 | $54.03 – $1,908.17 | 15 |
| X-ray spine single view CPT 72020 | $288.80 | $1,054.00 | $18.50 – $874.82 | 20 |
| X-ray sternum > 2 views CPT 71120 | $288.80 | $1,054.00 | $26.73 – $874.82 | 20 |
| X-ray surgical specimen CPT 76098 | $482.24 | $1,760.00 | $20.77 – $1,952.35 | 20 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $477.31 | $1,742.00 | $74.46 – $1,445.86 | 20 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $303.32 | $1,107.00 | $46.55 – $918.81 | 20 |
| X-ray thoracic spine 2 views CPT 72070 | $321.95 | $1,175.00 | $25.98 – $975.25 | 20 |
| X-ray thoracic spine 3 views CPT 72072 | $321.95 | $1,175.00 | $31.96 – $975.25 | 20 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $288.80 | $1,054.00 | $27.48 – $874.82 | 20 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $289.07 | $1,055.00 | $34.21 – $875.65 | 20 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $321.13 | $1,172.00 | $56.31 – $972.76 | 20 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $430.73 | $1,572.00 | $105.63 – $1,304.76 | 20 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $477.31 | $1,742.00 | $92.54 – $1,445.86 | 20 |
| Xylose absorption test blood &/or urine CPT 84620 | $3.54 | $12.90 | $1.42 – $28.58 | 21 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $46,676.45 | $170,352.00 | $18,738.72 – $158,495.36 | 20 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $38.64 | $141.00 | $0.02 – $94.62 | 14 |
| Zika virus dna/rna amp probe CPT 87662 | $36.17 | $132.00 | $14.52 – $113.62 | 21 |
| Zika virus igm antibody CPT 86794 | $20.50 | $74.80 | $8.23 – $62.09 | 21 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $72.07 | $263.00 | $5.49 – $41.50 | 17 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $5,699.20 | $20,800.00 | $9.24 – $87.98 | 17 |
| Zoster vaccine-live inj CPT 90736 | $279.76 | $1,021.00 | $84.70 – $639.10 | 16 |
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.