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 |
|---|---|---|---|---|
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $806.13 | $2,067.00 | $665.65 – $5,063.00 | 3 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $900.51 | $2,309.00 | $665.65 – $4,714.00 | 5 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | $6,536.79 | $16,761.00 | $1,694.00 – $9,136.47 | 5 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $8,630.31 | $22,129.00 | $1,694.00 – $9,087.85 | 5 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $1,694.00 – $5,063.00 | 3 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $1,118.91 | $2,869.00 | $1,694.00 – $5,272.00 | 5 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $900.51 | $2,309.00 | $665.65 – $3,391.00 | 5 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $262.86 | $674.00 | $665.65 – $3,391.00 | 5 |
| Clsd tx pelvic ring fx CPT 27197 | $541.71 | $1,389.00 | $665.65 – $3,391.00 | 4 |
| Clsd tx pelvic ring fx CPT 27198 | $541.71 | $1,389.00 | $665.65 – $3,391.00 | 4 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $9,945.00 | $25,500.00 | $1,308.00 – $4,536.58 | 5 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $3,446.82 | $8,838.00 | $1,308.00 – $4,536.58 | 5 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $276.90 | $710.00 | $665.65 – $3,391.00 | 5 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $3,272.10 | $8,390.00 | $1,694.00 – $4,714.00 | 5 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $973.44 | $2,496.00 | $1,694.00 – $4,714.00 | 5 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $7,791.81 | $19,979.00 | $1,308.00 – $5,272.00 | 5 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $9,945.00 | $25,500.00 | $1,308.00 – $9,136.47 | 5 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $559.65 | $1,435.00 | $665.65 – $3,391.00 | 5 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $900.51 | $2,309.00 | $665.65 – $3,391.00 | 5 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,707.42 | $4,378.00 | $1,308.00 – $4,536.58 | 5 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $730.08 | $1,872.00 | $665.65 – $3,391.00 | 5 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $900.51 | $2,309.00 | $665.65 – $3,391.00 | 3 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $900.51 | $2,309.00 | $665.65 – $5,063.00 | 3 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $806.13 | $2,067.00 | $665.65 – $4,714.00 | 5 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $900.51 | $2,309.00 | $665.65 – $5,063.00 | 3 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 5 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $9,945.00 | $25,500.00 | $665.65 – $4,714.00 | 5 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $3,082.17 | $7,903.00 | $1,694.00 – $4,714.00 | 5 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $9,945.00 | $25,500.00 | $1,694.00 – $5,272.00 | 5 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 5 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $3,446.82 | $8,838.00 | $1,308.00 – $4,536.58 | 5 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $900.51 | $2,309.00 | $665.65 – $3,391.00 | 5 |
| Cltx lunate dislc w/mnpj CPT 25690 | $9,945.00 | $25,500.00 | $1,308.00 – $5,272.00 | 5 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $6,776.64 | $17,376.00 | $1,937.00 – $16,529.94 | 5 |
| Cltx mndblr fx w/mnpj CPT 21451 | $4,218.24 | $10,816.00 | $2,323.00 – $6,389.00 | 5 |
| Cltx mndblr/max alv ridge fx CPT 21440 | not published | not published | $1,937.00 – $9,087.85 | 5 |
| Cltx palatal/max fx wire fix CPT 21421 | $3,610.62 | $9,258.00 | $2,323.00 – $9,087.85 | 5 |
| Cltx post ankle fx CPT 27767 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 4 |
| Cltx post ankle fx w/mnpj CPT 27768 | $973.44 | $2,496.00 | $2,572.00 – $4,536.58 | 4 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $3,446.82 | $8,838.00 | $1,308.00 – $4,536.58 | 5 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $262.86 | $674.00 | $665.65 – $3,391.00 | 5 |
| Cltx thigh fx CPT 27267 | $1,852.89 | $4,751.00 | $2,572.00 – $9,136.47 | 4 |
| Cltx thigh fx w/mnpj CPT 27268 | not published | not published | $3,391.00 – $8,448.00 | 2 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $2,664.00 – $14,039.62 | 5 |
| C motor evoked lwr limbs CPT 95929 | $571.74 | $1,466.00 | not published | 0 |
| C motor evoked uppr limbs CPT 95928 | $670.02 | $1,718.00 | not published | 0 |
| C motor evoked upr&lwr limbs CPT 95939 | $670.02 | $1,718.00 | not published | 0 |
| Cmp rpr tof wo plm atrs ptch CPT 33694 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Cmptr ophth dx img ant segmt CPT 92132 | $79.17 | $203.00 | $172.66 – $172.66 | 1 |
| Cmptr ophth img optic nerve CPT 92133 | $79.56 | $204.00 | $172.66 – $172.66 | 1 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $10.50 – $48.68 | 4 |
| #cms hgb-sulfhemoglobin CPT 83060 | $353.34 | $906.00 | $14.50 – $30.45 | 4 |
| #cmvcul-virus inoculation shell CPT 87254 | $102.57 | $263.00 | $34.26 – $67.68 | 4 |
| Cmv ig IV CPT 90291 | not published | not published | $3,750.38 – $3,750.38 | 1 |
| Cmv pcr-sendout CPT 87496 | $733.98 | $1,882.00 | $61.50 – $121.41 | 4 |
| Cnbp gene detc abnor allele CPT 81187 | $616.59 | $1,581.00 | $164.40 – $474.02 | 3 |
| Co2 monitor per day CPT 94681 | $652.86 | $1,674.00 | $885.97 – $885.97 | 1 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | not published | not published | $4.86 – $8.41 | 3 |
| Coagulation time activated teg CPT 85347 | $36.66 | $94.00 | $7.46 – $14.81 | 4 |
| Coagulation time lee & white CPT 85345 | not published | not published | $7.54 – $16.23 | 4 |
| Coagulation time otr method CPT 85348 | not published | not published | $6.53 – $15.54 | 4 |
| Cocaine 4 % nasal solution HCPCS C9046 | not published | not published | $2.97 – $3.31 | 2 |
| Cocaine hcl nasal (numbrino) HCPCS C9143 | not published | not published | $4.36 – $4.36 | 1 |
| Coccidioidomycosis skin test CPT 86490 | not published | not published | $6.61 – $172.66 | 4 |
| Coch imp ext proc/contr rplc HCPCS L8619 | not published | not published | $3,099.00 – $3,099.00 | 1 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $440.91 – $440.91 | 1 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $440.91 – $440.91 | 1 |
| Codeine 15 mg/ml inj 2 ml HCPCS J0745 | not published | not published | $359.45 – $359.45 | 1 |
| Cogenex amnio memb per sq cm HCPCS Q4229 | not published | not published | $993.08 – $993.08 | 1 |
| Cold agglutinin screen (arc) CPT 86156 | $74.49 | $191.00 | $11.74 – $27.92 | 4 |
| Cold agglutinin titer CPT 86157 | $23.01 | $59.00 | $14.12 – $27.89 | 4 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy prtl w/coloproctostomy 44145 CPT 44145 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy prtl w/coloproctostomy + colostomy 44146 CPT 44146 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy prtl w/skin level cecost/colostomy 44141 CPT 44141 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy/w colostomy or ileostomy 44144 CPT 44144 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy w/ileoanal anast CPT 44157 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colectomy w/neo-rectum pouch CPT 44158 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colistimethate sodium inj HCPCS J0770 | not published | not published | $23.18 – $23.18 | 1 |
| Collagenase, clost hist inj HCPCS J0775 | not published | not published | $135.12 – $229.29 | 3 |
| Collagen dressing <=16 sq in HCPCS A6021 | $3,236.71 | $8,299.25 | not published | 0 |
| Collagen imp urinary 2.5 ml HCPCS L8603 | $1,949.63 | $4,999.05 | $1,937.00 – $1,937.00 | 1 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $241.80 | $620.00 | $44.14 – $256.49 | 4 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $36.33 | $93.15 | 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.