Wellstar Sylvan Grove Hospital
1050 Mcdonough Road, Jackson, GA · Wellstar Health System · · NPI 1386664779
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 |
|---|---|---|---|---|
| Wilate injection HCPCS J7183 | not published | not published | $2.44 – $4.50 | 3 |
| Wnd prep f/n/hf/g addl cm CPT 15005 | $865.80 | $2,220.00 | $2,665.00 – $3,391.00 | 2 |
| Wound Cleaning and Dead Tissue Removal (up to 20 sq cm) CPT 97597 | $852.93 | $2,187.00 | $565.10 – $3,391.00 | 3 |
| Wound closure by adhesive HCPCS G0168 | not published | not published | $2,665.00 – $2,665.00 | 1 |
| Woundfix biowound plus xplus HCPCS Q4217 | not published | not published | $706.86 – $706.86 | 1 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $695.37 | $1,783.00 | $1,125.52 – $1,125.52 | 1 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $689.91 | $1,769.00 | $1,125.52 – $1,125.52 | 1 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $211.38 | $542.00 | $565.10 – $565.10 | 1 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $352.56 | $904.00 | $1,125.52 – $1,125.52 | 1 |
| Wrist arthroscopy CPT 29840 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Wrist arthroscopy/surgery CPT 29843 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $4,536.58 – $9,032.00 | 5 |
| Wrist X-ray CPT 73110 | $235.17 | $603.00 | $61.29 – $256.49 | 4 |
| Wrist X-ray (2 views, both wrists) CPT 73100 | $197.73 | $507.00 | $47.40 – $256.49 | 4 |
| Xcapsl ctrc rmvl cplx w/ecp CPT 66987 | not published | not published | $8,245.00 – $11,889.00 | 4 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $3,680.00 – $8,057.00 | 5 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $8,245.00 – $14,752.70 | 3 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $8,245.00 – $11,889.00 | 4 |
| Xcellistem, 1 mg HCPCS A2004 | not published | not published | $25.27 – $25.27 | 1 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $8,245.00 – $14,752.70 | 3 |
| Xe133 xenon 10mci HCPCS A9558 | $64.35 | $165.00 | $495.94 – $495.94 | 1 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $2,157.48 | $5,532.00 | $1,694.00 – $5,272.00 | 5 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $2,190.24 | $5,616.00 | $1,937.00 – $5,809.00 | 5 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $1,096.80 – $3,162.44 | 3 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $1,096.80 – $3,162.44 | 3 |
| Xm archive tissue molec anal CPT 88363 | $20.28 | $52.00 | $13.25 – $84.05 | 4 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | $2,338.05 | $5,995.00 | $5,063.00 – $6,859.00 | 2 |
| X-ray abdomen >=3 views CPT 74021 | $329.55 | $845.00 | $58.02 – $310.32 | 4 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $491.01 | $1,259.00 | $166.69 – $1,085.52 | 4 |
| X-ray assay calculus CPT 82370 | not published | not published | $21.95 – $43.32 | 4 |
| X-ray bone length studies CPT 77073 | $240.63 | $617.00 | $49.03 – $310.32 | 4 |
| X-ray bone survey infant CPT 77076 | $559.26 | $1,434.00 | $141.36 – $341.39 | 4 |
| Xray endovasc thor ao repr CPT 75956 | $5,261.88 | $13,492.00 | not published | 0 |
| Xray endovasc thor ao repr CPT 75957 | $7,990.32 | $20,488.00 | not published | 0 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $441.48 | $1,132.00 | $115.21 – $310.32 | 4 |
| X-ray exam entire spi 6/> vw CPT 72084 | $597.48 | $1,532.00 | $138.09 – $310.32 | 4 |
| X-ray exam of arm infant CPT 73092 | $248.82 | $638.00 | $44.95 – $310.32 | 4 |
| X-ray exam of femur 1 CPT 73551 | $168.09 | $431.00 | $44.95 – $256.49 | 4 |
| X-ray exam of jaw joint CPT 70328 | $240.63 | $617.00 | $49.03 – $256.49 | 4 |
| X-ray exam of jaw joint CPT 70332 | $370.89 | $951.00 | $112.76 – $691.66 | 4 |
| X-ray exam of mastoids CPT 70120 | $101.40 | $260.00 | $56.38 – $310.32 | 4 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $78.44 – $1,557.18 | 4 |
| X-ray exam of penis CPT 74445 | $171.99 | $441.00 | $94.84 – $960.34 | 4 |
| X-ray exam of perineum CPT 74775 | not published | not published | $129.18 – $960.34 | 4 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $61.29 – $256.49 | 4 |
| X-ray exam of tear duct CPT 70170 | $572.91 | $1,469.00 | $85.85 – $1,170.83 | 4 |
| X-ray exam of teeth CPT 70300 | not published | not published | $20.44 – $256.49 | 4 |
| X-ray exam of teeth CPT 70310 | not published | not published | $64.55 – $691.66 | 4 |
| X-ray exam si joints CPT 72200 | $169.65 | $435.00 | $44.95 – $310.32 | 4 |
| X-ray exam thorac spine4/>vw CPT 72074 | $414.57 | $1,063.00 | $64.55 – $310.32 | 4 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $238.29 | $611.00 | $44.14 – $256.49 | 4 |
| X-ray fallopian tube CPT 74742 | $609.57 | $1,563.00 | $198.80 – $256.45 | 2 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $22.07 – $256.49 | 4 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $271.05 | $695.00 | $85.80 – $310.32 | 4 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $304.98 | $782.00 | $93.15 – $310.32 | 4 |
| X-ray joint survey 1 view CPT 77077 | $187.20 | $480.00 | $48.22 – $310.32 | 4 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $256.62 | $658.00 | $44.95 – $256.49 | 4 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $342.42 | $878.00 | $48.66 – $310.32 | 4 |
| X-ray male genital tract CPT 74440 | $205.14 | $526.00 | $143.81 – $691.66 | 4 |
| X-ray mandible ltd <4 views CPT 70100 | $213.72 | $548.00 | $54.76 – $256.49 | 4 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $44.95 – $85.66 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $259.74 | $666.00 | $39.23 – $256.49 | 4 |
| X-ray of mammary ducts CPT 77054 | $504.27 | $1,293.00 | $125.83 – $691.66 | 4 |
| X-ray optic foramina CPT 70190 | $134.55 | $345.00 | $55.57 – $256.49 | 4 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $633.36 | $1,624.00 | $231.38 – $1,085.52 | 4 |
| X-ray ribs 2 views left CPT 71100 | $283.92 | $728.00 | $49.85 – $256.49 | 4 |
| X-ray sella turcica CPT 70240 | $221.52 | $568.00 | $46.58 – $256.49 | 4 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $414.96 | $1,064.00 | $66.19 – $1,557.18 | 4 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $618.93 | $1,587.00 | $138.09 – $333.57 | 4 |
| X-ray small intestine follow-through study CPT 74248 | $804.18 | $2,062.00 | not published | 0 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $514.80 | $1,320.00 | $56.38 – $256.49 | 4 |
| X-ray surgical specimen CPT 76098 | $457.47 | $1,173.00 | $19.62 – $1,557.18 | 4 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $273.00 | $700.00 | $58.84 – $256.49 | 4 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $190.38 – $409.96 | 2 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $288.42 – $636.03 | 2 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $136.45 – $518.62 | 4 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $5,540.74 – $5,540.74 | 1 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $20.75 – $44.67 | 4 |
| Xyntha inj HCPCS J7185 | not published | not published | $2.86 – $4.46 | 3 |
| Yersinia antibody CPT 86793 | $202.80 | $520.00 | $23.10 – $45.64 | 4 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $126,093.45 – $195,962.00 | 3 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $227.63 – $227.63 | 1 |
| Ziconotide injection HCPCS J2278 | not published | not published | $18.64 – $31.28 | 3 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $2.88 – $2.88 | 1 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $2.95 – $2.95 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $214.50 | $550.00 | $76.02 – $177.53 | 4 |
| Zika virus igm antibody CPT 86794 | $23.01 | $59.00 | $24.96 – $58.30 | 4 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $13.70 – $13.70 | 1 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $15.21 – $25.19 | 3 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $10.67 – $10.67 | 1 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $453.99 – $453.99 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $231.90 – $668.64 | 2 |
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.