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 |
|---|---|---|---|---|
| External chromosome analysis 20-25 cells CPT 88264 | $533.91 | $1,369.00 | $218.38 – $500.35 | 4 |
| External newborn metabolic screening panel HCPCS S3620 | $93.99 | $241.00 | not published | 0 |
| External ocular photography CPT 92285 | $62.40 | $160.00 | not published | 0 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $111.15 | $285.00 | $17.39 – $84.05 | 4 |
| External profiling gene expression oncology (breast) mrna 21 genes CPT 81519 | not published | not published | $4,099.01 – $13,400.58 | 3 |
| External recharg sys intern HCPCS L8689 | $10,113.85 | $25,932.96 | not published | 0 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $334.62 | $858.00 | $221.29 – $497.38 | 4 |
| Extnd color vision xm CPT 92283 | not published | not published | $172.66 – $172.66 | 1 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $134.94 | $346.00 | $31.42 – $62.04 | 4 |
| Extraction erupted tooth/exr HCPCS D7140 | not published | not published | $2,485.25 – $5,063.00 | 2 |
| Extraction of lens CPT 66930 | not published | not published | $2,664.00 – $11,476.46 | 5 |
| Extraction of lens CPT 66940 | not published | not published | $2,664.00 – $6,760.00 | 5 |
| Extraction of lens 66920 CPT 66920 | not published | not published | $2,323.00 – $6,577.81 | 5 |
| Extrnl counterpulse, per tx HCPCS G0166 | $643.11 | $1,649.00 | $360.57 – $2,572.00 | 2 |
| Eye allergy tests CPT 95060 | not published | not published | $360.57 – $360.57 | 1 |
| Eye implant band 40 HCPCS C1784 | $28,995.79 | $74,348.19 | not published | 0 |
| Eye photodynamic ther add-on CPT 67225 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Eye Socket (Orbit) X-ray CPT 70200 | $349.05 | $895.00 | $64.55 – $310.32 | 4 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $1,686.75 | $4,325.00 | $518.62 – $610.08 | 3 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,551.42 | $3,978.00 | $474.71 – $543.08 | 3 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $1,385.28 | $3,552.00 | $310.32 – $459.69 | 3 |
| Eye surgery follow-up add-on CPT 67331 | not published | not published | $2,323.00 – $6,389.00 | 3 |
| Eye suture during surgery CPT 67335 | not published | not published | $2,323.00 – $6,389.00 | 3 |
| Ezh2 gene common variants CPT 81237 | $288.21 | $739.00 | $210.48 – $606.88 | 3 |
| Ezh2 gene full gene sequence CPT 81236 | $465.66 | $1,194.00 | $339.46 – $978.76 | 3 |
| F-18 fdg pet diag HCPCS A9552 | $867.36 | $2,224.00 | not published | 0 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $5,224.83 | $13,397.00 | $5,555.13 – $5,555.13 | 1 |
| F-18 fluciclovine per mci HCPCS A9588 | $902.07 | $2,313.00 | $1,004.42 – $1,004.42 | 1 |
| F-18 sodium fluoride HCPCS A9580 | $226.20 | $580.00 | $424.52 – $424.52 | 1 |
| F9 full gene sequence CPT 81238 | $2,118.87 | $5,433.00 | $720.00 – $2,076.00 | 4 |
| Face bone graft CPT 21210 | not published | not published | $3,721.00 – $16,529.94 | 5 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $2,184.00 | $5,600.00 | $710.83 – $1,105.71 | 3 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $1,782.69 | $4,571.00 | $540.06 – $822.66 | 3 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $260.52 | $668.00 | $44.14 – $256.49 | 4 |
| Facial Bones X-ray (complete) CPT 70150 | $378.69 | $971.00 | $64.55 – $310.32 | 4 |
| Facial nerve function test CPT 92516 | not published | not published | $885.97 – $885.97 | 1 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $6,859.00 – $9,087.85 | 2 |
| Factor ix CPT 85250 | $280.80 | $720.00 | $33.35 – $65.88 | 4 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $6.82 – $12.01 | 3 |
| Factor ix complex HCPCS J7194 | not published | not published | $3.16 – $5.57 | 3 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $9.93 – $17.09 | 3 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $2.55 – $4.57 | 3 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $8.37 – $15.26 | 3 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $3.14 – $5.36 | 3 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $3.51 – $6.06 | 3 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $4.48 – $7.02 | 3 |
| Factor viii CPT 85240 | $280.80 | $720.00 | $31.37 – $61.93 | 4 |
| Factor viii HCPCS J7190 | not published | not published | $2.13 – $3.56 | 3 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $4.46 – $7.58 | 3 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $2.36 – $4.43 | 3 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $4.00 – $6.85 | 3 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $2.94 – $5.22 | 3 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $2.73 – $4.64 | 3 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $6.16 – $11.14 | 3 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $19.96 – $33.49 | 3 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $32.73 – $59.27 | 3 |
| Fallopian tube recnl CPT 58345 | $5,663.19 | $14,521.00 | $3,391.00 – $8,824.63 | 3 |
| Family therapy without pt 50min 90846 CPT 90846 | $184.86 | $474.00 | $450.03 – $450.03 | 1 |
| Family therapy with patient 50 min 90847 CPT 90847 | $204.75 | $525.00 | $450.03 – $450.03 | 1 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $54.91 – $94.25 | 3 |
| Fancc gene CPT 81242 | $490.23 | $1,257.00 | $43.94 – $126.71 | 3 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $4,714.00 – $15,026.00 | 2 |
| Fat/lipids feces qualitative CPT 82705 | $101.40 | $260.00 | $8.92 – $17.65 | 4 |
| Fatty acids nonesterified CPT 82725 | $49.92 | $128.00 | $23.33 – $64.94 | 4 |
| Fda ide #g240020 carry bag HCPCS Q0499 | $676.56 | $1,734.76 | not published | 0 |
| Fecal bilirubin test CPT 82252 | not published | not published | $7.97 – $15.78 | 4 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $121.22 – $217.91 | 2 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $2,579.78 – $3,391.00 | 2 |
| #fecal-sodium CPT 84302 | $52.65 | $135.00 | $8.52 – $16.82 | 4 |
| Feeding tube reposition CPT 74355 | $684.45 | $1,755.00 | $361.41 – $466.22 | 2 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $48.75 | $125.00 | $22.37 – $64.49 | 2 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Fem/popl revasc w/stent CPT 37226 | $12,656.28 | $32,452.00 | $6,389.00 – $31,052.45 | 3 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | not published | not published | $1.62 – $1.62 | 1 |
| Fern test HCPCS Q0114 | not published | not published | $12.53 – $33.70 | 3 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $2.12 – $3.98 | 3 |
| Ferritin CPT 82728 | $212.16 | $544.00 | $23.87 – $47.16 | 4 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.72 – $2.46 | 3 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.72 – $2.46 | 3 |
| Fetal aneuploidy trisom risk CPT 81507 | not published | not published | $954.00 – $2,750.70 | 2 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $525.33 | $1,347.00 | $160.97 – $339.80 | 4 |
| Fetal chrmoml microdeltj CPT 81422 | $1,234.74 | $3,166.00 | $962.80 – $2,626.31 | 4 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | not published | not published | $962.80 – $2,626.31 | 3 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $1,031.94 | $2,646.00 | $562.46 – $5,063.00 | 3 |
| Fetal cord puncture prenatal CPT 59012 | $626.34 | $1,606.00 | $905.52 – $5,063.00 | 3 |
| Fetal fibronectin CPT 82731 | $542.88 | $1,392.00 | $112.85 – $222.86 | 4 |
| Fetal fluid drainage w/us CPT 59074 | $626.34 | $1,606.00 | $905.52 – $3,391.00 | 4 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $124.02 | $318.00 | $13.56 – $26.75 | 4 |
| Fetal hemoglobin rosette CPT 85461 | $86.58 | $222.00 | $11.63 – $32.39 | 4 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $51.09 | $131.00 | $33.14 – $66.85 | 4 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Fetal monitor w/report CPT 59050 | not published | not published | $2,665.00 – $5,063.00 | 2 |
| Fetal non stress test CPT 59025 | $1,412.19 | $3,621.00 | $562.46 – $5,063.00 | 3 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $905.52 – $5,063.00 | 3 |
| Fetal shunt placement w/us CPT 59076 | $626.34 | $1,606.00 | $905.52 – $3,391.00 | 4 |
| #_fet/norfentcnfrmur CPT 80354 | not published | not published | $29.32 – $29.32 | 1 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $15.06 – $23.53 | 2 |
| Fibrin degradation d dimer quantitative CPT 85379 | $141.96 | $364.00 | $17.82 – $35.22 | 4 |
| Fibrin degradation products CPT 85362 | $90.48 | $232.00 | $12.07 – $23.84 | 4 |
| Fibrin degrade semiquant CPT 85378 | $203.58 | $522.00 | $12.49 – $33.63 | 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.