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 |
|---|---|---|---|---|
| Block tap inj(s) w/wo img bi CPT 64488 | $3,543.54 | $9,086.00 | $2,665.00 – $4,714.00 | 2 |
| Block tap inj(s) w/wo img uni CPT 64486 | $3,354.39 | $8,601.00 | $2,665.00 – $4,714.00 | 2 |
| Blood clot lysis time CPT 85175 | not published | not published | $7.97 – $70.48 | 4 |
| Blood clot retraction CPT 85170 | not published | not published | $6.34 – $56.40 | 4 |
| Blood Clotting (PT/INR) Test CPT 85610 | $68.25 | $175.00 | $6.89 – $14.84 | 4 |
| Blood Clotting (PTT) Test CPT 85730 | $79.56 | $204.00 | $10.51 – $20.79 | 4 |
| Blood Count (CBC) Test CPT 85025 | $105.69 | $271.00 | $12.37 – $26.88 | 4 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $83.85 | $215.00 | $11.34 – $22.39 | 4 |
| Blood count spun microhematocrit CPT 85013 | $50.31 | $129.00 | $4.15 – $24.22 | 4 |
| Blood Culture Test CPT 87040 | $171.99 | $441.00 | $18.08 – $35.71 | 4 |
| Blood draw capillary 36416 CPT 36416 | $26.91 | $69.00 | $3.44 – $4.26 | 2 |
| Blood Draw (Venipuncture) CPT 36415 | $12.48 | $32.00 | $3.60 – $30.55 | 3 |
| Blood gases o2 saturation direct measurement CPT 82805 | $277.29 | $711.00 | $49.72 – $272.54 | 4 |
| Blood gases ph venous CPT 82800 | $131.82 | $338.00 | $14.84 – $38.06 | 4 |
| Blood, l/r, irradiated HCPCS P9056 | $476.58 | $1,222.00 | not published | 0 |
| Blood mucoprotein HCPCS P2038 | not published | not published | $8.81 – $17.13 | 3 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $124.80 | $320.00 | $27.86 – $55.08 | 4 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $48.36 | $124.00 | $5.70 – $14.64 | 4 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $37.05 | $95.00 | $5.70 – $15.15 | 4 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $52.65 | $135.00 | $5.70 – $18.41 | 4 |
| Blood smear interpretation CPT 85060 | $86.58 | $222.00 | $26.83 – $37.66 | 3 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $38.61 | $99.00 | $6.02 – $13.15 | 4 |
| Blood split unit HCPCS P9011 | $344.37 | $883.00 | not published | 0 |
| Blood thymol turbidity HCPCS P2033 | not published | not published | $7.33 – $17.13 | 2 |
| Blood Transfusion CPT 36430 | $1,782.30 | $4,570.00 | $1,225.32 – $3,391.00 | 4 |
| Blood typing abo CPT 86900 | $98.67 | $253.00 | $5.22 – $360.57 | 4 |
| Blood typing ag donor ea ag CPT 86902 | $306.15 | $785.00 | $6.46 – $1,014.60 | 4 |
| Blood typing antigen system CPT 86911 | not published | not published | $17.32 – $49.84 | 3 |
| Blood typing paternity test CPT 86910 | $86.58 | $222.00 | $19.91 – $58.01 | 3 |
| Blood typing patient serum CPT 86904 | $172.77 | $443.00 | $16.66 – $172.66 | 4 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $181.74 | $466.00 | $6.68 – $1,014.60 | 4 |
| Blood typing rh (d) CPT 86901 | $78.39 | $201.00 | $5.22 – $113.20 | 4 |
| Blood typing rh phenotype complete reference CPT 86906 | $418.47 | $1,073.00 | $13.57 – $113.20 | 4 |
| Blood volume CPT 78122 | not published | not published | $180.60 – $1,525.66 | 4 |
| Bls-emergency HCPCS A0429 | $892.32 | $2,288.00 | $484.00 – $2,026.52 | 2 |
| Blue light cysto imag agent HCPCS C9738 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $218.40 | $560.00 | $31.06 – $310.32 | 4 |
| Bone biopsy open superficial CPT 20240 | $5,178.42 | $13,278.00 | $1,694.00 – $8,020.55 | 5 |
| Bone Density Scan (DEXA) CPT 77080 | $407.94 | $1,046.00 | $71.10 – $310.32 | 4 |
| Bone imaging (3d) CPT 78320 | not published | not published | $427.35 – $846.34 | 2 |
| Bone imaging multiple areas CPT 78305 | $909.48 | $2,332.00 | $457.57 – $1,164.18 | 4 |
| Bone/joint imaging ltd area CPT 78300 | $732.03 | $1,877.00 | $360.34 – $1,164.18 | 4 |
| Bone marrow;aspiration only 38220 CPT 38220 | $2,147.73 | $5,507.00 | $2,572.00 – $4,576.34 | 4 |
| Bone marrow aspir bone grfg CPT 20939 | $2,147.73 | $5,507.00 | $2,665.00 – $3,391.00 | 2 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $2,577.12 | $6,608.00 | $2,572.00 – $4,576.34 | 4 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $4,330.86 – $6,760.00 | 3 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $5,809.00 – $13,062.71 | 4 |
| Bone marrow imaging body CPT 78104 | $641.94 | $1,646.00 | $496.79 – $1,164.18 | 4 |
| Bone marrow imaging ltd CPT 78102 | $591.63 | $1,517.00 | $344.83 – $1,164.18 | 4 |
| Bone marrow imaging mult CPT 78103 | $610.74 | $1,566.00 | $442.05 – $1,164.18 | 4 |
| Bone marrow interpretation CPT 85097 | $375.96 | $964.00 | $41.46 – $2,427.15 | 4 |
| Bone mineral dual photon CPT 78351 | not published | not published | $24.51 – $46.23 | 3 |
| Bone mineral single photon CPT 78350 | $312.39 | $801.00 | $50.67 – $104.35 | 3 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Bone/skin graft iliac crest CPT 20970 | not published | not published | $2,323.00 – $11,889.00 | 3 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Bone/skin graft microvasc CPT 20969 | not published | not published | $2,323.00 – $11,889.00 | 3 |
| Bone survey-lead poisoning CPT 77074 | $217.23 | $557.00 | $95.61 – $310.32 | 4 |
| Bone tendon board add on HCPCS C9356 | not published | not published | $207.32 – $207.32 | 1 |
| Boot cast sandal rocker med HCPCS L3265 | $123.12 | $315.68 | not published | 0 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $509.81 | $1,307.20 | not published | 0 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | $131.59 | $337.41 | not published | 0 |
| Borrelia antibody CPT 86619 | not published | not published | $23.45 – $46.29 | 4 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $48.75 | $125.00 | $29.84 – $58.92 | 4 |
| Borrelia miyamotoi amp prb CPT 87478 | not published | not published | $121.41 – $121.41 | 1 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | not published | not published | $4.23 – $118.46 | 3 |
| (both sides) donor search management CPT 38204 | $4,321.98 | $11,082.00 | $5,063.00 – $5,063.00 | 1 |
| (both sides) smear without diff wbc count CPT 85008 | $38.22 | $98.00 | $6.02 – $11.87 | 4 |
| Botulism ig IV CPT 90288 | not published | not published | $92,831.73 – $92,831.73 | 1 |
| Bowel imaging CPT 78290 | $745.29 | $1,911.00 | $714.95 – $1,434.14 | 4 |
| Bpg axillary-pop/-tibial CPT 35623 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg carotid-vertebral CPT 35642 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg ilio-celiac CPT 35632 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg ilio-mesenteric CPT 35633 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg iliorenal CPT 35634 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg pop-tibl/-prnl artery CPT 35671 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg splenorenal CPT 35636 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg subclavian-axillary CPT 35616 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Bpg subclavian-vertebral CPT 35645 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Brace afo lg left 6607 HCPCS L1930 | $318.48 | $816.62 | not published | 0 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | $459.44 | $1,178.04 | not published | 0 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $2,150.44 | $5,513.96 | not published | 0 |
| Brace back t-lso custom HCPCS L0486 | $1,764.07 | $4,523.26 | not published | 0 |
| Brace cust back lso HCPCS L0631 | $1,407.93 | $3,610.08 | not published | 0 |
| Brace fx hum ovr shldr sm HCPCS L3980 | $420.76 | $1,078.88 | not published | 0 |
| Brace knee extender plus 22-30in HCPCS L1832 | $1,014.05 | $2,600.13 | not published | 0 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $60.06 | $154.00 | not published | 0 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $1,867.28 | $4,787.91 | not published | 0 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $1,338.34 | $3,431.65 | not published | 0 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $348.84 | $894.45 | not published | 0 |
| Brace wrist classic lft sm HCPCS L3908 | $81.62 | $209.28 | not published | 0 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $1,937.00 – $8,020.55 | 5 |
| Brach/thor cath 1st CPT 36215 | $1,294.02 | $3,318.00 | $2,665.00 – $4,714.00 | 2 |
| Brach/thor cath 2nd CPT 36216 | $2,750.67 | $7,053.00 | $2,665.00 – $4,714.00 | 2 |
| Brach/thor cath 3rd CPT 36217 | $3,295.50 | $8,450.00 | $2,665.00 – $4,714.00 | 2 |
| Brach/thor cath addl CPT 36218 | $1,351.35 | $3,465.00 | $2,665.00 – $4,714.00 | 2 |
| Brachy source i-125 injection HCPCS C2638 | $36.57 | $93.77 | not published | 0 |
| Brachy source iodine-125 nonstranded HCPCS C2639 | $43.23 | $110.85 | not published | 0 |
| Brachy source palladium HCPCS C2640 | $182.53 | $468.03 | not published | 0 |
| Brachy source palladium-103 nonstranded HCPCS C2641 | $62.77 | $160.94 | not published | 0 |
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.