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 |
|---|---|---|---|---|
| Dry needling (97799) CPT 97799 | $114.27 | $293.00 | not published | 0 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $1,308.00 – $10,913.47 | 5 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $4,967.04 | $12,736.00 | $2,572.00 – $6,179.00 | 4 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $1,125.52 – $4,714.00 | 4 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $1,125.52 – $3,391.00 | 3 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $1,772.77 – $3,391.00 | 4 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $1,772.77 – $4,714.00 | 3 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $1,640.73 – $4,066.00 | 4 |
| Ductogram sgl duct CPT 77053 | $450.06 | $1,154.00 | $93.15 – $691.66 | 4 |
| Duodenal exclusion CPT 48547 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Duodenal motility study CPT 91022 | not published | not published | $1,512.89 – $3,391.00 | 3 |
| Duplex scan bilateral study 93985 CPT 93985 | $1,034.28 | $2,652.00 | $691.66 – $691.66 | 1 |
| Duplex scan unilateral study 93986 CPT 93986 | $689.91 | $1,769.00 | $310.32 – $310.32 | 1 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $752.70 | $1,930.00 | $310.32 – $905.80 | 4 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,104.09 | $2,831.00 | $339.08 – $729.59 | 3 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $688.74 | $1,766.00 | $388.11 – $1,021.16 | 3 |
| Duragen 1x1 5ea/bx HCPCS C9354 | not published | not published | $36.94 – $36.94 | 1 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $159.88 – $279.26 | 3 |
| Dxa bone density axl vrt fx CPT 77085 | $532.35 | $1,365.00 | $93.15 – $310.32 | 4 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $440.91 – $440.91 | 1 |
| Dx bronchoscope/brush 31623 CPT 31623 | $3,215.94 | $8,246.00 | $1,694.00 – $5,272.00 | 5 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $3,215.94 | $8,246.00 | $1,694.00 – $5,272.00 | 5 |
| Dx bronchoscope/wash 31622 CPT 31622 | $3,215.94 | $8,246.00 | $1,308.00 – $5,272.00 | 5 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $2,558.69 – $5,272.00 | 4 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $2,558.69 – $5,272.00 | 4 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $885.97 – $3,391.00 | 4 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $440.91 – $3,391.00 | 4 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $1,152.56 – $3,391.00 | 3 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $697.61 – $5,272.00 | 3 |
| Dynamic fine wire emg CPT 96003 | not published | not published | $885.97 – $885.97 | 1 |
| Dynamic surface emg CPT 96002 | $268.71 | $689.00 | $885.97 – $885.97 | 1 |
| Ear and throat examination CPT 92502 | not published | not published | $1,308.00 – $2,665.00 | 3 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $4,304.67 – $5,272.00 | 3 |
| Ear cartilage graft CPT 21235 | not published | not published | $3,721.00 – $16,529.94 | 5 |
| Ear irrigation 69209 CPT 69209 | $149.76 | $384.00 | $172.66 – $3,391.00 | 3 |
| Ecallantide injection HCPCS J1290 | not published | not published | $1,073.27 – $1,866.08 | 3 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $118.56 | $304.00 | $172.66 – $172.66 | 1 |
| Ecg < 30 days transmission & analysis CPT 93271 | $120.12 | $308.00 | not published | 0 |
| Ecg external < 48 hours recording CPT 93225 | $461.76 | $1,184.00 | $360.57 – $360.57 | 1 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $584.22 | $1,498.00 | $172.66 – $172.66 | 1 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $58.50 | $150.00 | not published | 0 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $96.72 | $248.00 | not published | 0 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,835.34 | $4,706.00 | not published | 0 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $615.42 | $1,578.00 | $268.24 – $691.66 | 3 |
| Echocardiography doppler color flow mapping CPT 93325 | $344.76 | $884.00 | $57.93 – $74.73 | 2 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,070.12 | $5,308.00 | not published | 0 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $615.42 | $1,578.00 | $1,085.52 – $1,085.52 | 1 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $244.53 | $627.00 | $59.15 – $76.30 | 2 |
| Echo exam of eye CPT 76516 | $105.30 | $270.00 | $109.49 – $310.32 | 4 |
| Echo exam of eye CPT 76519 | $161.46 | $414.00 | $122.57 – $310.32 | 4 |
| Echo exam of eye CPT 76529 | $107.64 | $276.00 | $107.87 – $256.49 | 4 |
| Echo exam of eye thickness CPT 76514 | $32.37 | $83.00 | $12.27 – $84.05 | 4 |
| Echo exam of fetal heart CPT 76825 | $405.99 | $1,041.00 | $451.84 – $1,557.18 | 4 |
| Echo exam of fetal heart CPT 76826 | $261.69 | $671.00 | $284.34 – $691.66 | 4 |
| Echo exam of fetal heart CPT 76827 | $226.20 | $580.00 | $108.68 – $310.32 | 4 |
| Echo exam of fetal heart CPT 76828 | $423.54 | $1,086.00 | $58.84 – $310.32 | 4 |
| Echo exam uterus 76831- CPT 76831 | $448.50 | $1,150.00 | $192.82 – $691.66 | 4 |
| Echograp trans r pros study CPT 76873 | $262.86 | $674.00 | $215.71 – $445.81 | 4 |
| Echo guidance radiotherapy CPT 76965 | $1,201.98 | $3,082.00 | $86.94 – $112.15 | 2 |
| Echo guidance radiotherapy HCPCS G6001 | not published | not published | $50.67 – $98.88 | 3 |
| Echo guide cardiocentesis CPT 76930 | not published | not published | $249.37 – $249.37 | 1 |
| Echo guide for amniocentesis CPT 76946 | $493.35 | $1,265.00 | $49.49 – $63.84 | 2 |
| Echo guide for artery repair CPT 76936 | $1,939.47 | $4,973.00 | $404.45 – $885.97 | 4 |
| Echo guide for heart biopsy CPT 76932 | $1,116.57 | $2,863.00 | $195.16 – $251.76 | 2 |
| Echo guide for transfusion CPT 76941 | $497.25 | $1,275.00 | $207.20 – $267.29 | 2 |
| Echo guide ova aspiration CPT 76948 | $493.35 | $1,265.00 | $50.68 – $65.38 | 2 |
| Echo guide villus sampling CPT 76945 | $139.62 | $358.00 | $214.45 – $276.64 | 2 |
| Echo stress CPT 93350 | $2,299.44 | $5,896.00 | $598.65 – $1,557.18 | 2 |
| Echo tee guidance CPT 93355 | $1,753.44 | $4,496.00 | not published | 0 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,404.00 | $3,600.00 | $723.77 – $1,557.18 | 3 |
| Echo transesophageal CPT 93313 | $405.60 | $1,040.00 | not published | 0 |
| Echo transesophageal CPT 93314 | not published | not published | $804.72 – $1,038.09 | 2 |
| Echo transesophageal CPT 93315 | $923.13 | $2,367.00 | $1,387.47 – $1,789.84 | 3 |
| Echo transesophageal CPT 93317 | $473.85 | $1,215.00 | not published | 0 |
| Echo transesophageal intraop CPT 93318 | $1,093.17 | $2,803.00 | $1,557.18 – $2,560.10 | 3 |
| Echo transthoracic CPT 93303 | $1,220.31 | $3,129.00 | $480.97 – $1,557.18 | 3 |
| Echo transthoracic CPT 93304 | $585.39 | $1,501.00 | $338.35 – $1,557.18 | 3 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $661.83 | $1,697.00 | $248.92 – $691.66 | 3 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | $7,630.74 | $19,566.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | $7,242.30 | $18,570.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls initiation artery 33947 CPT 33947 | $13,573.56 | $34,804.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls initiation venous 33946 CPT 33946 | $13,573.56 | $34,804.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls insj cent cannula 0-5yrs 33955 CPT 33955 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls insj cent cannula 6yrs&older 33956 CPT 33956 | $7,346.04 | $18,836.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls insj prph cannula 0-5yrs opn 33953 CPT 33953 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls insj prph cannula 0-5yrs perq 33951 CPT 33951 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 | $8,167.38 | $20,942.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | $8,167.38 | $20,942.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls remove cent cannula 0-5yrs 33985 CPT 33985 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls remove cent cannula 6yrs&older 33986 CPT 33986 | $3,672.63 | $9,417.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls remove perph cannula 0-5yrs opn 33969 CPT 33969 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls remove perph cannula 0-5yrs perq 33965 CPT 33965 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls remove prph cannula 6yrs&older open 33984 CPT 33984 | $3,672.63 | $9,417.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls remove prph cannula 6yrs&older perq 33966 CPT 33966 | $4,083.69 | $10,471.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls repos cent cnula 6yrs&older 33964 CPT 33964 | $3,672.63 | $9,417.00 | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls repos cent/perph cnula 0-5yrs 33963 CPT 33963 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls repos perph cnula 0-5yrs opn 33959 CPT 33959 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls repos perph cnula 0-5yrs perq 33957 CPT 33957 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ecmo/ecls repos perph cnula 6yrs&older opn 33962 CPT 33962 | $3,672.63 | $9,417.00 | $5,063.00 – $6,859.00 | 2 |
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.