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 |
|---|---|---|---|---|
| Collar cerv adlt perfit ace extric HCPCS L0140 | $534.84 | $1,371.38 | not published | 0 |
| Collar cerv ascend 172 reg HCPCS L0172 | $127.71 | $327.47 | not published | 0 |
| Collar extrication adult univ HCPCS L0200 | $764.15 | $1,959.36 | not published | 0 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $344.37 | $883.00 | $360.57 – $2,665.00 | 2 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $179.79 | $461.00 | $360.57 – $2,665.00 | 2 |
| Coll-e-derm 1 sq cm HCPCS Q4193 | not published | not published | $3,791.03 – $3,791.03 | 1 |
| Colon motility 6 hr study CPT 91117 | not published | not published | $885.97 – $2,665.00 | 2 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy flex with decompression 45393 CPT 45393 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy for bleeding 44391 CPT 44391 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Colonoscopy for foreign body CPT 44390 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Colonoscopy & polypectomy 44392 CPT 44392 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Colonoscopy stoma w/endo mucosal rescj 44403 CPT 44403 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Colonoscopy submucous njx CPT 45381 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy thru stoma spx CPT 44388 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Colonoscopy w/ablation CPT 45388 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy w/balloon dilat CPT 45386 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy w/band ligation CPT 45398 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy w/control bleed CPT 45382 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy w/decompression CPT 44408 | not published | not published | $2,579.78 – $5,272.00 | 4 |
| Colonoscopy w/dilation CPT 44405 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy w/endoscopic fnb CPT 45392 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy/w endoscopic stent 45389 CPT 45389 | not published | not published | $4,714.00 – $16,086.99 | 4 |
| Colonoscopy w/fb removal CPT 45379 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy w/injection CPT 44404 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy with ablation CPT 44401 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy with biopsy CPT 44389 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Colonoscopy w/ndl aspir/bx CPT 44407 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colonoscopy w/resection CPT 45390 | not published | not published | $4,714.00 – $7,925.42 | 4 |
| Colonoscopy w/stent plcmt CPT 44402 | not published | not published | $3,391.00 – $16,086.99 | 4 |
| Colonoscopy w/ultrasound CPT 44406 | not published | not published | $3,330.93 – $5,272.00 | 4 |
| Colostomy skin level cecostomy 44320 CPT 44320 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colostomy with biopsies CPT 44322 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Colotomy exploration/bx/foreign body removal 44025 CPT 44025 | not published | not published | $6,859.00 – $8,245.00 | 2 |
| Colpocentesis 57020 CPT 57020 | not published | not published | $1,694.00 – $14,039.62 | 5 |
| Colpocleisis (le forte type) 57120 CPT 57120 | not published | not published | $6,760.00 – $14,039.62 | 3 |
| Colpopexy abdominal approach 57280 CPT 57280 | not published | not published | $6,179.00 – $6,760.00 | 2 |
| Colpopexy extraperitoneal CPT 57282 | not published | not published | $6,760.00 – $21,329.47 | 3 |
| Colpopexy intraperitoneal CPT 57283 | not published | not published | $6,760.00 – $21,329.47 | 3 |
| Colpopexy, min/inv, ex-perit HCPCS C9778 | not published | not published | $6,179.00 – $14,039.62 | 3 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | not published | not published | $1,308.00 – $8,824.63 | 5 |
| Colposcopy/cervix/bx vagina/cervix 57421 CPT 57421 | $829.14 | $2,126.00 | $2,269.16 – $4,066.00 | 4 |
| Colposcopy/cervix/ conization 57461 CPT 57461 | not published | not published | $3,437.00 – $8,824.63 | 4 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $329.94 | $846.00 | $562.46 – $4,714.00 | 5 |
| Colposcopy vulva 56820 CPT 56820 | $99.84 | $256.00 | $562.46 – $3,391.00 | 3 |
| Colposcopy vulva w/biopsy 56821 CPT 56821 | not published | not published | $905.52 – $3,391.00 | 4 |
| Colposcopy w/biopsy of cervix 57455 CPT 57455 | $390.00 | $1,000.00 | $905.52 – $3,391.00 | 4 |
| Colpotomy drng of abscess 57010 CPT 57010 | not published | not published | $1,694.00 – $8,824.63 | 5 |
| Colpotomy w/exploration 57000 CPT 57000 | not published | not published | $1,308.00 – $8,824.63 | 5 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $308.88 | $792.00 | $30.18 – $482.12 | 4 |
| Compatibility test each unit electronic CPT 86923 | $191.49 | $491.00 | $17.39 – $482.12 | 4 |
| Compatibility test each unit immediate spin technique CPT 86920 | $217.23 | $557.00 | $17.39 – $482.12 | 4 |
| Compatibility test incubate CPT 86921 | $171.60 | $440.00 | $17.39 – $482.12 | 4 |
| Comp cystometrogram/void presssure 51728 CPT 51728 | $1,399.32 | $3,588.00 | $1,928.18 – $4,066.00 | 3 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | $1,399.32 | $3,588.00 | $1,928.18 – $4,066.00 | 3 |
| Complement antigen each component c3 CPT 86160 | $157.17 | $403.00 | $21.04 – $41.52 | 4 |
| Complement fixation each CPT 86171 | $99.06 | $254.00 | $17.56 – $34.63 | 4 |
| Complete removal of vulva CPT 56625 | not published | not published | $3,721.00 – $8,824.63 | 5 |
| Completion pneumonectomy 32488 CPT 32488 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Complex body section x-ray CPT 76101 | not published | not published | $222.25 – $556.52 | 2 |
| Complex body section x-rays CPT 76102 | not published | not published | $318.67 – $795.09 | 2 |
| Complex cystometrogram 51726 CPT 51726 | not published | not published | $697.61 – $3,391.00 | 5 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $1,727.70 | $4,430.00 | $1,694.00 – $4,714.00 | 5 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $2,221.44 | $5,696.00 | $1,772.77 – $5,809.00 | 5 |
| Complex uroflowmetry (electronic) 51741 CPT 51741 | $346.71 | $889.00 | $885.97 – $5,063.00 | 3 |
| Compl oph exam general anes CPT 92018 | not published | not published | $1,308.00 – $6,595.97 | 3 |
| Compl rpr tof w/pulm atresia CPT 33697 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $2,221.44 | $5,696.00 | $1,772.77 – $5,809.00 | 5 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $2,221.44 | $5,696.00 | $1,772.77 – $5,809.00 | 5 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $1,727.70 | $4,430.00 | $2,323.00 – $5,809.00 | 3 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $1,727.70 | $4,430.00 | $1,125.52 – $4,714.00 | 5 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $1,930.50 | $4,950.00 | $1,772.77 – $5,809.00 | 5 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $1,930.50 | $4,950.00 | $2,323.00 – $3,391.00 | 3 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $1,727.70 | $4,430.00 | $2,323.00 – $3,391.00 | 3 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $2,221.44 | $5,696.00 | $1,694.00 – $4,714.00 | 5 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $376.35 | $965.00 | $2,323.00 – $3,391.00 | 3 |
| Composite byp grft 2 veins CPT 35682 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Composite byp grft 3/> segmt CPT 35683 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Composite byp grft pros&vein CPT 35681 | $1,267.50 | $3,250.00 | $5,063.00 – $6,859.00 | 2 |
| Composite graft/pri close/don area 15760 CPT 15760 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Comprehensive hearing test CPT 92557 | $394.29 | $1,011.00 | $440.91 – $440.91 | 1 |
| Compre oph exam est pt 1/> CPT 92014 | $113.10 | $290.00 | not published | 0 |
| Compre oph exam new pt 1/> CPT 92004 | $146.64 | $376.00 | not published | 0 |
| Comp rpr tof wo pulm atresia CPT 33692 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Concentration infection agents any type CPT 87015 | $80.34 | $206.00 | $11.70 – $23.11 | 4 |
| Conditioning play audiometry 92582 CPT 92582 | $189.15 | $485.00 | $440.91 – $440.91 | 1 |
| Conduit wrap neuomend 3mmx2.5cm HCPCS C9361 | not published | not published | $337.86 – $337.86 | 1 |
| Condylomata destruction 56420 CPT 56420 | $799.50 | $2,050.00 | $562.46 – $3,391.00 | 4 |
| Congo red blood test HCPCS P2029 | not published | not published | $7.33 – $17.13 | 2 |
| Conivaptan hcl HCPCS C9488 | not published | not published | $86.65 – $141.38 | 3 |
| Conization/cerv/loop electrode exc 57522 CPT 57522 | $1,053.00 | $2,700.00 | $1,694.00 – $8,824.63 | 5 |
| Conization of cervix CPT 57520 | not published | not published | $1,694.00 – $8,824.63 | 5 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | not published | not published | $729.83 – $1,287.64 | 3 |
| Connect omega .5mm HCPCS L8613 | $40,292.75 | $103,314.74 | not published | 0 |
| Connector tis 2x10mm HCPCS C9352 | $3,630.83 | $9,309.83 | $1,959.20 – $1,959.20 | 1 |
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.