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 |
|---|---|---|---|---|
| Drainage of mouth lesion CPT 41016 | not published | not published | $1,308.00 – $16,529.94 | 5 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $1,308.00 – $9,087.85 | 5 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Drainage of nose lesion int 30000 CPT 30000 | $1,857.57 | $4,763.00 | $689.46 – $3,391.00 | 3 |
| Drainage of nose lesion sept 30020 CPT 30020 | $579.93 | $1,487.00 | $1,553.04 – $3,391.00 | 3 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $1,308.00 – $6,179.00 | 5 |
| Drainage of pelvis lesion 26990 CPT 26990 | $11,916.06 | $30,554.00 | $1,308.00 – $9,136.47 | 5 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $1,694.00 – $9,840.21 | 5 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $1,308.00 – $9,840.21 | 5 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $1,694.00 – $9,840.21 | 5 |
| Drainage of rectal abscess CPT 45005 | $6,838.65 | $17,535.00 | $1,694.00 – $5,272.00 | 5 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $1,694.00 – $7,925.42 | 5 |
| Drainage of salivary gland CPT 42305 | not published | not published | $1,694.00 – $9,087.85 | 5 |
| Drainage of salivary gland CPT 42320 | not published | not published | $1,308.00 – $3,391.00 | 5 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drainage of spinal cyst CPT 63173 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drainage of throat abscess CPT 42725 | not published | not published | $1,694.00 – $16,529.94 | 5 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $1,694.00 – $9,840.21 | 5 |
| Drainage of urethra abscess 53060 CPT 53060 | $2,459.34 | $6,306.00 | $3,391.00 – $6,179.00 | 3 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $1,928.18 – $6,179.00 | 5 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $5,063.00 – $6,179.00 | 3 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $2,951.19 – $5,272.00 | 3 |
| Drain blood from under nail 11740 CPT 11740 | $238.68 | $612.00 | $360.57 – $3,391.00 | 3 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $3,343.47 | $8,573.00 | $4,220.00 – $5,809.00 | 4 |
| Drain cath image guided visceral pq CPT 49405 | $3,765.45 | $9,655.00 | $4,576.34 – $9,032.00 | 4 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,113.06 | $2,854.00 | $1,308.00 – $4,066.00 | 5 |
| Drain chest lesion CPT 21502 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $85.57 | $219.42 | not published | 0 |
| Drain finger abscess;simple 26010 CPT 26010 | $794.82 | $2,038.00 | $565.10 – $5,063.00 | 4 |
| Drain lower leg bursa CPT 27604 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Drain lower leg lesion 27603 CPT 27603 | $6,118.71 | $15,689.00 | $1,694.00 – $8,020.55 | 5 |
| Drain neck/chest lesion 21501 CPT 21501 | $4,391.40 | $11,260.00 | $1,694.00 – $8,020.55 | 5 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $2,323.00 – $8,824.63 | 4 |
| Drain ovary abscess open CPT 58820 | not published | not published | $1,937.00 – $8,824.63 | 5 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drain penis lesion CPT 54015 | not published | not published | $2,323.00 – $6,389.00 | 5 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $1,937.00 – $6,179.00 | 5 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $1,937.00 – $8,020.55 | 5 |
| Drain shoulder lesion CPT 23030 | not published | not published | $1,308.00 – $8,020.55 | 5 |
| Drain thigh/knee lesion 27301 CPT 27301 | $5,827.38 | $14,942.00 | $1,937.00 – $8,020.55 | 5 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $852.93 | $2,187.00 | $565.10 – $4,714.00 | 5 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $852.93 | $2,187.00 | $565.10 – $3,391.00 | 4 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $852.93 | $2,187.00 | $1,125.52 – $4,714.00 | 5 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $1,248.78 | $3,202.00 | $1,772.77 – $3,391.00 | 3 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $85.47 – $85.47 | 1 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | $6,472.44 | $16,596.00 | $5,063.00 – $6,859.00 | 2 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $1,737.06 | $4,454.00 | $5,063.00 – $6,859.00 | 2 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $1,308.00 – $3,391.00 | 3 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $1,308.00 – $3,391.00 | 3 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Drng of eyelid abscess 67700 CPT 67700 | $1,583.40 | $4,060.00 | $822.27 – $3,391.00 | 5 |
| Drng of finger abscess comp 26011 CPT 26011 | $6,307.08 | $16,172.00 | $1,308.00 – $5,272.00 | 5 |
| Drng of hydrocele 55000 CPT 55000 | $1,834.56 | $4,704.00 | $1,985.95 – $5,063.00 | 3 |
| Drng of mouth lesion 40801 CPT 40801 | $3,772.47 | $9,673.00 | $1,553.04 – $4,714.00 | 5 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $1,937.00 – $8,824.63 | 5 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $1,308.00 – $9,136.47 | 5 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $1,937.00 – $9,087.85 | 5 |
| Drng of scrotum abscess 55100 CPT 55100 | $7,053.54 | $18,086.00 | $1,308.00 – $5,272.00 | 5 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $5,809.00 – $8,448.00 | 2 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $1,308.00 – $5,272.00 | 5 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $1,308.00 – $3,391.00 | 5 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $3.53 – $3.53 | 1 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $18.83 – $18.83 | 1 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,650.12 | $4,231.08 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $60.20 | $154.37 | $23.79 – $23.79 | 1 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $50.30 | $128.97 | $23.01 – $23.01 | 1 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $19.48 – $19.48 | 1 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $288.32 – $288.32 | 1 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $46.49 – $46.49 | 1 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $99.87 – $99.87 | 1 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | $301.63 | $773.40 | not published | 0 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $392.06 – $392.06 | 1 |
| Drug admin & hemodynmic meas CPT 93463 | $301.47 | $773.00 | $2,665.00 – $2,665.00 | 1 |
| Drug assay caffeine CPT 80155 | $155.61 | $399.00 | $23.16 – $133.45 | 4 |
| Drug assay posaconazole CPT 80187 | $39.39 | $101.00 | $32.53 – $93.80 | 2 |
| Drug assay rufinamide CPT 80210 | not published | not published | $32.53 – $93.80 | 2 |
| Drug assay vedolizumab CPT 80280 | $63.57 | $163.00 | $46.28 – $133.45 | 2 |
| Drug assay voriconazole CPT 80285 | $44.46 | $114.00 | $32.53 – $93.80 | 2 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $22.37 – $64.49 | 2 |
| Drug of abuse screen urine CPT 80305 | $303.81 | $779.00 | $17.36 – $43.60 | 4 |
| Drug screening tapentadol CPT 80372 | not published | not published | $25.87 – $25.87 | 1 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $10.57 – $93.80 | 4 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $29.66 – $29.66 | 1 |
| Drug test def 15-21 classes HCPCS G0482 | $263.25 | $675.00 | $71.23 – $687.64 | 4 |
| Drug test def 1-7 classes HCPCS G0480 | $263.25 | $675.00 | $34.30 – $395.93 | 4 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $92.34 – $854.34 | 4 |
| Drug test def 8-14 classes HCPCS G0481 | $263.25 | $675.00 | $52.76 – $541.80 | 4 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $95.77 – $215.00 | 3 |
| Drug test prsmv instrmnt CPT 80306 | not published | not published | $23.94 – $59.30 | 4 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $128.31 | $329.00 | $95.77 – $215.00 | 4 |
| Drvvt confirm - quest CPT 85597 | $90.48 | $232.00 | $31.50 – $62.21 | 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.