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 |
|---|---|---|---|---|
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $2,664.00 – $11,889.00 | 5 |
| Acth stimulation panel CPT 80402 | not published | not published | $149.24 – $300.88 | 4 |
| Acth stimulation panel CPT 80406 | not published | not published | $137.11 – $314.55 | 4 |
| Actigraphy testing CPT 95803 | $89.70 | $230.00 | $172.66 – $172.66 | 1 |
| Actinotherapy uv light CPT 96900 | $63.96 | $164.00 | not published | 0 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $56.16 | $144.00 | $84.05 – $84.05 | 1 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | $154.05 | $395.00 | not published | 0 |
| Acup 1/> without estim ea add 15 CPT 97811 | $154.05 | $395.00 | not published | 0 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $42.90 | $110.00 | $84.05 – $84.05 | 1 |
| Acute hepatitis panel CPT 80074 | $409.50 | $1,050.00 | $83.45 – $175.66 | 4 |
| Acute venous thrombus image CPT 78456 | $492.57 | $1,263.00 | $649.58 – $4,008.07 | 4 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | not published | not published | $0.10 – $0.10 | 1 |
| #acylcarnitineprfl CPT 82017 | $202.02 | $518.00 | $29.56 – $58.37 | 4 |
| Acylcarnitines qual CPT 82016 | not published | not published | $24.29 – $57.06 | 4 |
| Adalimumab injection HCPCS J0135 | not published | not published | $4,501.32 – $5,490.38 | 2 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $450.03 – $450.03 | 1 |
| Adapter b 8 channel 10cm HCPCS C1883 | $19,520.11 | $50,051.56 | not published | 0 |
| Adding walker to prev cast CPT 29440 | $185.64 | $476.00 | $444.76 – $5,063.00 | 3 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | not published | not published | $0.61 – $0.61 | 1 |
| Adenovirus ag ia CPT 87301 | $22.62 | $58.00 | $21.02 – $41.45 | 4 |
| Adenovirus antibody,serum - quest CPT 86603 | $104.52 | $268.00 | $22.55 – $44.53 | 4 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $21.02 – $75.29 | 4 |
| Adenovirus vaccine type 4 CPT 90476 | not published | not published | $137.67 – $137.67 | 1 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $6,179.00 – $6,760.00 | 2 |
| Adh-sendout CPT 84588 | $371.67 | $953.00 | $59.47 – $117.43 | 4 |
| Adj gastric band via subq port CPT 43999 | $1,666.86 | $4,274.00 | $2,558.69 – $5,272.00 | 3 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $2,786.55 | $7,145.00 | $1,937.00 – $5,809.00 | 5 |
| Adjustment gastric band HCPCS S2083 | $501.54 | $1,286.00 | $3,391.00 – $3,391.00 | 1 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | not published | not published | $0.44 – $0.44 | 1 |
| Admin ecg contrast agent CPT 93352 | $187.59 | $481.00 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $198.51 | $509.00 | $81.08 – $198.84 | 2 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $456.30 | $1,170.00 | $177.72 – $198.84 | 2 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $695.37 | $1,783.00 | $370.12 – $955.94 | 2 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $437.19 | $1,121.00 | $285.49 – $955.94 | 2 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $442.26 | $1,134.00 | $80.08 – $198.84 | 2 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $495.69 | $1,271.00 | $198.84 – $209.05 | 2 |
| Administration immunization each additional vaccine CPT 90472 | $62.79 | $161.00 | not published | 0 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $62.79 | $161.00 | $198.84 – $198.84 | 1 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $62.79 | $161.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | $62.79 | $161.00 | not published | 0 |
| Administration vaccine influenza virus HCPCS G0008 | $62.79 | $161.00 | not published | 0 |
| Administration vaccine pneumococcal HCPCS G0009 | $62.79 | $161.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $78.09 – $132.76 | 3 |
| Adrenal cortex & medulla img CPT 78075 | $710.19 | $1,821.00 | $975.59 – $4,008.07 | 4 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Adrenalin epinephrine inject HCPCS J0171 | not published | not published | $1.45 – $1.45 | 1 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $121.68 | $312.00 | not published | 0 |
| Aep hearing status deter i&r CPT 92651 | $241.41 | $619.00 | $885.97 – $885.97 | 1 |
| Aep neurodiagnostic i&r CPT 92653 | $379.08 | $972.00 | $885.97 – $885.97 | 1 |
| Aep thrshld est mlt freq i&r CPT 92652 | $379.08 | $972.00 | $885.97 – $885.97 | 1 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $6,125.10 – $8,599.46 | 2 |
| _afb id by dna probe rflx ast CPT 87149 | $38.22 | $98.00 | $35.12 – $69.37 | 4 |
| #afb mycobacteria suscep. #1 CPT 87190 | $73.71 | $189.00 | $9.90 – $25.29 | 4 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $378.69 | $971.00 | $198.26 – $399.15 | 4 |
| Aff2 gen aly detc abnl allel CPT 81171 | $225.42 | $578.00 | $164.40 – $474.02 | 3 |
| Aff2 gen alys charac alleles CPT 81172 | $452.40 | $1,160.00 | $329.80 – $950.91 | 3 |
| Aflibercept injection HCPCS J0178 | not published | not published | $1,526.84 – $2,983.49 | 3 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $22.66 – $32.09 | 2 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $1,200.70 | $3,078.71 | not published | 0 |
| After cataract laser surgery CPT 66821 | $721.89 | $1,851.00 | $1,640.73 – $4,714.00 | 5 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $426.03 – $755.46 | 3 |
| Ag detect nos ia single CPT 87450 | not published | not published | $17.38 – $30.23 | 2 |
| Air conduction bilat CPT 92552 | $81.12 | $208.00 | $360.57 – $360.57 | 1 |
| Air injection into abdomen 49400 CPT 49400 | $2,454.66 | $6,294.00 | $1,308.00 – $3,391.00 | 3 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $484.38 | $1,242.00 | $440.91 – $440.91 | 1 |
| Albumin body fluid quantitative each specimen CPT 82042 | $91.65 | $235.00 | $9.07 – $26.92 | 4 |
| Albumin (human), 25%, 50ml HCPCS P9047 | not published | not published | $87.49 – $183.66 | 3 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $53.77 – $73.46 | 3 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $90.52 – $183.66 | 3 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $27.80 – $63.76 | 3 |
| Albumin ischemia modified CPT 82045 | not published | not published | $59.47 – $117.43 | 4 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $139.62 | $358.00 | $10.14 – $20.00 | 4 |
| Albumin serum plasma or whole blood CPT 82040 | $53.82 | $138.00 | $8.68 – $17.13 | 4 |
| Albuterol comp con HCPCS J7610 | not published | not published | $2.34 – $2.34 | 1 |
| Albuterol comp unit HCPCS J7609 | not published | not published | $0.97 – $0.97 | 1 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.36 – $0.36 | 1 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.30 – $0.30 | 1 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.13 – $0.13 | 1 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $36.27 | $93.00 | $20.72 – $59.75 | 2 |
| Alcohols biomarkers 3/more CPT 80322 | not published | not published | $17.64 – $17.64 | 1 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $84.05 – $84.05 | 1 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $450.03 – $450.03 | 1 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $10,057.44 – $11,800.83 | 3 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $170.62 – $434.23 | 4 |
| Alefacept HCPCS J0215 | not published | not published | $79.37 – $79.37 | 1 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $4,599.86 – $8,042.22 | 3 |
| Alglucerase injection HCPCS J0205 | not published | not published | $80.11 – $80.11 | 1 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $310.24 – $445.52 | 3 |
| Alkaline phosphatase CPT 84075 | $65.91 | $169.00 | $9.07 – $17.92 | 4 |
| Allergen alpha lactalbumin ige CPT 86008 | $33.93 | $87.00 | $26.57 – $62.04 | 4 |
| Allergen egg white ige CPT 86003 | $37.05 | $95.00 | $9.14 – $18.06 | 4 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $53.82 | $138.00 | $13.97 – $27.58 | 4 |
| Allergy injections; 2 or more 95117 CPT 95117 | $37.44 | $96.00 | not published | 0 |
| Allergy injection; single 95115 CPT 95115 | $51.48 | $132.00 | not published | 0 |
| Allergy Skin Testing CPT 95004 | $53.43 | $137.00 | not published | 0 |
| Allg patch or app # of tests 95044 CPT 95044 | $39.00 | $100.00 | not published | 0 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $5,809.00 – $37,149.33 | 3 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | not published | not published | $32.50 – $32.50 | 1 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $165.25 – $165.25 | 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.