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 |
|---|---|---|---|---|
| Chemodenervation anal musc CPT 46505 | not published | not published | $2,572.00 – $5,272.00 | 4 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $783.90 | $2,010.00 | $836.02 – $3,391.00 | 4 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $822.27 – $3,391.00 | 4 |
| Chemodenerv eccrine glands CPT 64653 | $521.82 | $1,338.00 | $836.02 – $3,391.00 | 4 |
| Chemodenerv eccrine glands 64650 CPT 64650 | $521.82 | $1,338.00 | $836.02 – $3,391.00 | 4 |
| Chemodenerv musc migraine 64615 CPT 64615 | $781.56 | $2,004.00 | $836.02 – $3,391.00 | 3 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $783.90 | $2,010.00 | $836.02 – $3,391.00 | 3 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | $430.17 | $1,103.00 | $836.02 – $3,391.00 | 3 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | $1,895.01 | $4,859.00 | $1,952.00 – $4,066.00 | 3 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | $1,973.40 | $5,060.00 | $1,952.00 – $4,066.00 | 3 |
| Chemo extend IV infus w/pump HCPCS G0498 | $1,124.37 | $2,883.00 | not published | 0 |
| Chemo ia infuse each addl hr CPT 96423 | $198.51 | $509.00 | $134.08 – $219.24 | 2 |
| Chemo ia infusion up to 1 hr CPT 96422 | $604.89 | $1,551.00 | $482.51 – $955.94 | 2 |
| Chemo ia push tecnique CPT 96420 | $618.93 | $1,587.00 | $276.38 – $955.94 | 2 |
| Chemo intralesional over 7 CPT 96406 | $757.38 | $1,942.00 | $122.01 – $605.00 | 2 |
| Chemo intralesional up to 7 96405 CPT 96405 | $618.93 | $1,587.00 | $78.49 – $198.84 | 2 |
| Chemotaxis assay CPT 86155 | not published | not published | $28.00 – $55.33 | 4 |
| Chemotherapy injection 96542 CPT 96542 | $482.04 | $1,236.00 | $111.05 – $955.94 | 2 |
| Chemotx admn pertl cav impl CPT 96446 | $437.19 | $1,121.00 | $77.62 – $955.94 | 2 |
| Chest 2 vws w oblique CPT 71048 | $385.71 | $989.00 | $58.85 – $310.32 | 4 |
| Chest apical lordotic proj CPT 71047 | $316.68 | $812.00 | $57.21 – $256.49 | 4 |
| Chest CT scan (with and without contrast) CPT 71270 | $1,918.02 | $4,918.00 | $473.07 – $537.39 | 3 |
| Chest CT scan (with contrast) CPT 71260 | $1,562.34 | $4,006.00 | $384.01 – $518.62 | 3 |
| Chest CT scan (without contrast) CPT 71250 | $1,540.50 | $3,950.00 | $297.41 – $343.51 | 3 |
| Chest Physiotherapy (first session) CPT 94667 | $514.41 | $1,319.00 | $360.57 – $360.57 | 1 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $401.31 | $1,029.00 | $360.57 – $360.57 | 1 |
| Chest Ultrasound CPT 76604 | $377.91 | $969.00 | $142.17 – $310.32 | 4 |
| Chest X-ray CPT 71046 | $294.06 | $754.00 | $44.96 – $256.49 | 4 |
| Chest X-ray (single view) CPT 71045 | $252.72 | $648.00 | $24.56 – $256.49 | 4 |
| Chg pr pul rehab for copd patients CPT 94626 | $133.77 | $343.00 | $172.66 – $172.66 | 1 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $770.25 | $1,975.00 | $518.62 – $518.62 | 1 |
| Chikungunya vaccine live im CPT 90589 | not published | not published | $587.05 – $587.05 | 1 |
| Chimerism anal no cell selec CPT 81267 | $210.21 | $539.00 | $339.64 – $717.81 | 4 |
| Chimerism anal w/cell select CPT 81268 | $1,110.72 | $2,848.00 | $426.94 – $902.33 | 4 |
| Chlamydia culture CPT 87110 | $215.28 | $552.00 | $34.32 – $67.82 | 4 |
| Chlamydia trachomatis ag if CPT 87270 | $80.34 | $206.00 | $21.02 – $41.45 | 4 |
| Chlamydia type CPT 87140 | $239.07 | $613.00 | $9.77 – $19.27 | 4 |
| Chlmyd pneum dna dir probe CPT 87485 | not published | not published | $35.12 – $69.37 | 4 |
| Chlmyd pneum dna quant CPT 87487 | not published | not published | $75.05 – $148.23 | 4 |
| Chlnggrphy intraop addl s&i CPT 74301 | $337.35 | $865.00 | $69.86 – $90.12 | 2 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $94.58 – $94.58 | 1 |
| Chlordiazepoxide injection HCPCS J1990 | not published | not published | $40.12 – $40.12 | 1 |
| Chloride CPT 82435 | $62.01 | $159.00 | $8.04 – $15.92 | 4 |
| Chloride 24 hour urine CPT 82436 | $65.91 | $169.00 | $8.81 – $19.90 | 4 |
| Chloroprocaine (clorotekal) HCPCS J2402 | not published | not published | $0.59 – $0.59 | 1 |
| Chloroprocaine hcl injection HCPCS J2401 | not published | not published | $0.06 – $0.14 | 2 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $1.16 – $2.46 | 2 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | not published | not published | $115.24 – $115.24 | 1 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | not published | not published | $58.09 – $58.09 | 1 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | not published | not published | $0.69 – $0.69 | 1 |
| Chmotx admn plrl cav thrcnts CPT 96440 | $437.19 | $1,121.00 | $334.64 – $955.94 | 2 |
| Cholangiogram percutaneous compl CPT 47532 | $2,155.92 | $5,528.00 | $4,714.00 – $9,765.44 | 4 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $639.99 | $1,641.00 | $116.87 – $150.76 | 2 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $6,859.00 – $8,245.00 | 2 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $6,760.00 – $6,859.00 | 2 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $4,031.04 | $10,336.00 | $5,063.00 – $9,765.44 | 3 |
| Cholera vaccine live oral CPT 90625 | not published | not published | $587.05 – $587.05 | 1 |
| Cholesterol CPT 82465 | $76.44 | $196.00 | $7.63 – $15.05 | 4 |
| Cholesterol body fluid CPT 84999 | $108.42 | $278.00 | $28.70 – $28.70 | 1 |
| Cholesterol (Lipid) Test CPT 80061 | $166.92 | $428.00 | $23.48 – $62.09 | 4 |
| Choline c-11 HCPCS A9515 | not published | not published | $9,720.60 – $9,720.60 | 1 |
| Cholinesterase CPT 82480 | $110.76 | $284.00 | $13.81 – $27.23 | 4 |
| Cholinesterase challenge CPT 95857 | not published | not published | $885.97 – $885.97 | 1 |
| Chorion biopsy CPT 59015 | $893.10 | $2,290.00 | $2,269.16 – $5,063.00 | 3 |
| Chorionic gonadotropin/1000u HCPCS J0725 | not published | not published | $37.49 – $37.49 | 1 |
| Chrom analysis CPT 88273 | $462.93 | $1,187.00 | $56.29 – $120.44 | 4 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $34.34 – $134.94 | 4 |
| Chromatography CPT 83021 | $120.51 | $309.00 | $31.64 – $62.49 | 4 |
| Chromogenic substrate assay CPT 85130 | $225.42 | $578.00 | $20.84 – $41.14 | 4 |
| Chromo high res and frag x - sendout CPT 81243 | $888.03 | $2,277.00 | $68.45 – $197.36 | 3 |
| Chromosome analys amniotic CPT 88269 | $722.67 | $1,853.00 | $291.41 – $600.86 | 4 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $303.41 – $599.17 | 4 |
| Chromosome analysis 15-20 cell count CPT 88262 | $1,066.26 | $2,734.00 | $218.38 – $434.20 | 4 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $260.82 – $599.17 | 4 |
| Chromosome analysis 45 CPT 88263 | $1,266.72 | $3,248.00 | $263.30 – $520.00 | 4 |
| Chromosome analysis 5 CPT 88261 | $878.67 | $2,253.00 | $309.66 – $914.62 | 4 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $303.41 – $599.17 | 4 |
| Chromosome analys placenta CPT 88267 | not published | not published | $314.96 – $652.45 | 4 |
| Chromosome banding study CPT 88283 | $235.95 | $605.00 | $120.18 – $237.36 | 4 |
| Chromosome count additional CPT 88285 | $434.07 | $1,113.00 | $33.29 – $93.11 | 4 |
| Chromosome karyotype study CPT 88280 | $434.07 | $1,113.00 | $43.97 – $115.81 | 4 |
| Chromosome study additional CPT 88289 | $147.03 | $377.00 | $60.34 – $119.13 | 4 |
| Chronic urticaria - sendout CPT 86343 | $119.34 | $306.00 | $21.84 – $43.11 | 4 |
| Chylomicron screen, bf - sendout CPT 82664 | $114.27 | $293.00 | $60.19 – $212.79 | 4 |
| Cid ext speech process repl HCPCS L8627 | $17,338.78 | $44,458.42 | not published | 0 |
| Cidofovir injection HCPCS J0740 | not published | not published | $573.90 – $1,917.50 | 3 |
| Cilastatin sodium injection HCPCS J0743 | not published | not published | $13.72 – $13.72 | 1 |
| Ciliary transsleral therapy CPT 66710 | $336.18 | $862.00 | $1,694.00 – $6,595.97 | 5 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $0.03 – $0.03 | 1 |
| Cinacalcet 30 mg tablet HCPCS J0604 | not published | not published | $0.04 – $0.04 | 1 |
| Cine/video x-rays CPT 76120 | $136.50 | $350.00 | $150.35 – $310.32 | 4 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $109.59 – $141.37 | 2 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | not published | not published | $1.58 – $1.58 | 1 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $55.05 – $89.84 | 3 |
| Circum 28 days or older CPT 54161 | $5,118.75 | $13,125.00 | $1,694.00 – $6,179.00 | 5 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $2,490.15 | $6,385.00 | $1,694.00 – $6,179.00 | 5 |
| Circumcision (newborn) CPT 54150 | $1,751.88 | $4,492.00 | $1,308.00 – $6,179.00 | 5 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | not published | not published | $5.13 – $5.13 | 1 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $606.06 | $1,554.00 | $395.41 – $1,140.10 | 4 |
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.