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 |
|---|---|---|---|---|
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $245.70 | $630.00 | $0.53 – $0.53 | 1 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $2.82 – $2.82 | 1 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.23 – $0.23 | 1 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $249.80 | $640.50 | $28.02 – $28.02 | 1 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $29.64 | $76.00 | $36.90 – $72.90 | 4 |
| Galactokinase - sendout CPT 82759 | not published | not published | $37.64 – $74.32 | 4 |
| Galactose transferase test CPT 82776 | not published | not published | $14.69 – $40.62 | 4 |
| Galectin-3 CPT 82777 | not published | not published | $21.36 – $153.10 | 4 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,078.74 | $2,766.00 | $705.95 – $1,616.55 | 4 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,078.74 | $2,766.00 | $969.05 – $2,213.61 | 4 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $1,937.00 – $16,286.66 | 4 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $14.73 – $22.90 | 2 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $1,480.66 – $2,730.98 | 3 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $1,512.26 – $2,789.24 | 3 |
| Gallium illuccix 1 millicure HCPCS A9596 | $1,395.27 | $3,577.61 | $1,913.01 – $3,070.81 | 2 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $1,601.95 – $2,614.08 | 2 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $3.96 – $3.96 | 1 |
| Galsulfase injection HCPCS J1458 | not published | not published | $924.26 – $1,601.95 | 3 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $941.87 – $1,755.12 | 3 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $94.19 – $175.53 | 3 |
| Gammaglobulin iga CPT 82784 | $176.28 | $452.00 | $16.30 – $32.18 | 4 |
| Gammaglobulin ige CPT 82785 | $168.48 | $432.00 | $28.86 – $56.95 | 4 |
| Gamma glutamyltransferase CPT 82977 | $76.44 | $196.00 | $12.61 – $24.91 | 4 |
| Gammagraft HCPCS Q4111 | not published | not published | $13.97 – $13.97 | 1 |
| Gammaplex injection HCPCS J1557 | not published | not published | $108.20 – $190.82 | 3 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $93.41 – $172.27 | 3 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | not published | not published | $54.78 – $54.78 | 1 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $32,325.76 – $32,325.76 | 1 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $61.50 – $121.41 | 4 |
| Gardner vag dna quant CPT 87512 | $150.54 | $386.00 | $73.14 – $144.49 | 4 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $9.20 – $23.22 | 4 |
| Gastric emptying imag study CPT 78265 | $989.82 | $2,538.00 | $840.78 – $1,662.60 | 4 |
| Gastric emptying imag study CPT 78266 | not published | not published | $1,005.82 – $1,989.40 | 4 |
| Gastric motility studies CPT 91020 | not published | not published | $1,512.89 – $3,391.00 | 3 |
| Gastric mucosa imaging CPT 78261 | $497.25 | $1,275.00 | $508.23 – $1,164.18 | 4 |
| Gastrin test CPT 82938 | not published | not published | $31.00 – $61.21 | 4 |
| Gastroduodenostomy CPT 43810 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gastroesophageal reflux study CPT 78262 | $452.79 | $1,161.00 | $502.51 – $1,164.18 | 4 |
| Gastroesophageal reflux test CPT 91034 | $4,235.01 | $10,859.00 | $1,512.89 – $2,665.00 | 2 |
| Gastrointestinal repair CPT 43360 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gastrointestinal repair CPT 43361 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gastrojejunostomy w/vagotomy CPT 43825 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gastroplasty duodenal switch CPT 43845 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $2,558.69 – $5,272.00 | 3 |
| Gated heart multiple CPT 78473 | $1,157.91 | $2,969.00 | $522.95 – $1,164.18 | 4 |
| Gba gene CPT 81251 | not published | not published | $56.70 – $163.48 | 3 |
| Gefitinib oral HCPCS J8565 | not published | not published | $272.58 – $272.58 | 1 |
| Gel cap app device for trach HCPCS L8515 | $8.88 | $22.77 | not published | 0 |
| Gel-one HCPCS J7326 | not published | not published | $1,003.28 – $3,230.35 | 3 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $1.07 – $5.94 | 3 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | not published | not published | $5.47 – $5.47 | 1 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | not published | not published | $444.33 – $782.93 | 3 |
| General health panel CPT 80050 | $329.55 | $845.00 | $48.47 – $107.03 | 3 |
| Generator barostim neo2 2014 HCPCS C1767 | $70,637.61 | $181,122.08 | not published | 0 |
| Generator emblem MRI sicd subq HCPCS C1722 | $39,114.89 | $100,294.60 | not published | 0 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $66,636.36 | $170,862.46 | not published | 0 |
| Genetic counseling 30 min CPT 96040 | $334.62 | $858.00 | not published | 0 |
| Genetic tstg severe inh cond CPT 81443 | $4,028.70 | $10,330.00 | $2,938.27 – $8,472.02 | 3 |
| Genioplasty augmentation CPT 21120 | not published | not published | $3,721.00 – $16,529.94 | 5 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $3,721.00 – $9,087.85 | 5 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $3,721.00 – $9,087.85 | 5 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $3,721.00 – $16,529.94 | 5 |
| Gen, neuro, clo loop, rechg HCPCS C1826 | $29,789.37 | $76,383.00 | not published | 0 |
| Genome re-evaluation CPT 81427 | not published | not published | $2,805.18 – $8,088.27 | 3 |
| Genome sequence analysis CPT 81425 | $6,404.58 | $16,422.00 | $6,037.44 – $17,407.95 | 3 |
| Genome sequence analysis CPT 81426 | not published | not published | $3,251.94 – $9,376.43 | 3 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | not published | not published | $4.71 – $4.71 | 1 |
| Gentamicin peak therapeutic drug level CPT 80170 | $160.68 | $412.00 | $28.72 – $56.67 | 4 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $11.76 – $44.84 | 3 |
| G-esoph reflx tst w/electrod CPT 91035 | $613.86 | $1,574.00 | $1,512.89 – $2,665.00 | 2 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Ghs abscess perianal iandd CPT 46050 | $6,838.65 | $17,535.00 | $1,308.00 – $4,066.00 | 5 |
| Ghs abscess postoperative iandd complex CPT 10180 | $9,703.59 | $24,881.00 | $1,694.00 – $8,020.55 | 5 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $94.77 | $243.00 | $13.46 – $33.94 | 4 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $182.13 | $467.00 | $28.16 – $59.20 | 4 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $543.66 | $1,394.00 | $122.71 – $353.82 | 3 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $567.06 | $1,454.00 | $360.57 – $360.57 | 1 |
| Ghs antibodies (torch) igm CPT 86694 | $96.33 | $247.00 | $25.22 – $49.79 | 4 |
| Ghs aspiration bladder - needle CPT 51100 | $590.85 | $1,515.00 | $697.61 – $3,391.00 | 3 |
| Ghs bladder cath - complex-foley CPT 51703 | $587.73 | $1,507.00 | $440.91 – $3,391.00 | 4 |
| Ghs bleeding time (ivy) CPT 85002 | $72.54 | $186.00 | $7.88 – $16.68 | 4 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,895.01 | $4,859.00 | $1,308.00 – $4,066.00 | 5 |
| Ghs central line insert < age 5, failed CPT 36555 | $6,195.93 | $15,887.00 | $1,308.00 – $8,997.17 | 5 |
| Ghs change cysto/gastrost CPT 43762 | $731.64 | $1,876.00 | $697.61 – $3,391.00 | 4 |
| Ghs chemo >8 hrs CPT 96416 | $714.87 | $1,833.00 | $376.52 – $955.94 | 2 |
| Ghs chemo infusion >8 hrs CPT 96425 | $570.57 | $1,463.00 | $504.73 – $955.94 | 2 |
| Ghs chemo IV push, ea addtl CPT 96411 | $395.46 | $1,014.00 | $152.83 – $198.84 | 2 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $232.44 | $596.00 | $61.50 – $121.41 | 4 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $900.51 | $2,309.00 | $665.65 – $5,063.00 | 3 |
| Ghs closed reduction ankle dislocation CPT 27840 | $3,446.82 | $8,838.00 | $665.65 – $3,391.00 | 5 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,707.42 | $4,378.00 | $1,308.00 – $4,536.58 | 5 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 5 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $5,509.53 | $14,127.00 | $1,308.00 – $5,272.00 | 5 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $2,588.04 | $6,636.00 | $1,694.00 – $5,272.00 | 5 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $806.13 | $2,067.00 | $665.65 – $3,391.00 | 5 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $5,509.53 | $14,127.00 | $1,308.00 – $5,272.00 | 5 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $5,509.53 | $14,127.00 | $1,694.00 – $5,272.00 | 5 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $900.51 | $2,309.00 | $665.65 – $3,391.00 | 5 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $806.13 | $2,067.00 | $665.65 – $5,063.00 | 3 |
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.