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 |
|---|---|---|---|---|
| Ghs nerve block suprascapular CPT 64418 | $2,625.09 | $6,731.00 | $1,952.00 – $4,066.00 | 4 |
| Ghs ng placement w fluoro guidance CPT 43752 | $1,182.09 | $3,031.00 | $1,124.66 – $4,714.00 | 3 |
| Ghs o2 saturation CPT 82810 | $108.81 | $279.00 | $15.29 – $33.80 | 4 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $440.91 – $440.91 | 1 |
| Ghs o2 uptake rest & indirect CPT 94690 | $521.04 | $1,336.00 | $172.66 – $172.66 | 1 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,593.93 | $4,087.00 | $1,694.00 – $4,714.00 | 5 |
| Ghs opcc repair cvp w subq port CPT 36576 | $5,005.65 | $12,835.00 | $1,694.00 – $4,714.00 | 5 |
| Ghs optokenetic CPT 92544 | not published | not published | $440.91 – $440.91 | 1 |
| Ghs oscillating trac CPT 92545 | not published | not published | $885.97 – $885.97 | 1 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $55.77 | $143.00 | not published | 0 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $46.80 | $120.00 | not published | 0 |
| Ghs ot dds rom CPT 95851 | $186.03 | $477.00 | not published | 0 |
| Ghs ot group caregiver training CPT 97552 | $30.03 | $77.00 | not published | 0 |
| Ghs ot prosthetic training/15 min CPT 97761 | $99.45 | $255.00 | not published | 0 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $48.75 | $125.00 | not published | 0 |
| Ghs ot work hardening-additional hours CPT 97546 | $49.14 | $126.00 | not published | 0 |
| Ghs pacing - transcutaneous CPT 92953 | $2,132.91 | $5,469.00 | $1,837.05 – $4,066.00 | 2 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $583.83 | $1,497.00 | $2,665.00 – $3,391.00 | 2 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,346.28 | $3,452.00 | $2,665.00 – $3,391.00 | 2 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $125.97 | $323.00 | $38.26 – $48.80 | 3 |
| Ghs peritonsillar abscess i andd CPT 42700 | $1,857.57 | $4,763.00 | $689.46 – $3,391.00 | 5 |
| Ghs phenylketonurid CPT 84030 | $175.11 | $449.00 | $9.65 – $19.03 | 4 |
| Ghs picc line insert < 5 CPT 36568 | $6,195.93 | $15,887.00 | $1,308.00 – $4,520.58 | 5 |
| Ghs plngl fx pm cl CPT 26725 | $806.13 | $2,067.00 | $665.65 – $4,714.00 | 3 |
| Ghs plt ct-manual CPT 85032 | $76.44 | $196.00 | $7.54 – $14.91 | 4 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $3,557.58 | $9,122.00 | not published | 0 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $360.57 – $360.57 | 1 |
| Ghs ppd (tb intradermal) CPT 86580 | $37.44 | $96.00 | $6.61 – $84.05 | 4 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $127.92 | $328.00 | $16.92 – $33.42 | 4 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $9.07 – $19.41 | 4 |
| Ghs protoporphyrins fract CPT 84202 | $171.21 | $439.00 | $25.14 – $49.65 | 4 |
| Ghs pr without cont pulse ox CPT 94625 | $133.77 | $343.00 | $172.66 – $172.66 | 1 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $85.80 | $220.00 | $21.46 – $42.38 | 4 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $116.61 | $299.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $112.71 | $289.00 | $25.57 – $50.52 | 4 |
| Ghs refill of implantable pump CPT 95990 | $422.37 | $1,083.00 | $955.94 – $2,665.00 | 2 |
| Ghs removal intranasal foreign body CPT 30300 | $368.55 | $945.00 | $360.57 – $5,063.00 | 3 |
| Ghs removal pharyngeal foreign body CPT 42809 | $329.16 | $844.00 | $1,124.66 – $3,391.00 | 4 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,799.07 | $4,613.00 | $1,937.00 – $5,809.00 | 5 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $197.73 | $507.00 | $22.58 – $54.98 | 4 |
| Ghs reticulocyte count CPT 85044 | $74.49 | $191.00 | $7.54 – $14.91 | 4 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $173.94 | $446.00 | $21.02 – $48.13 | 4 |
| Ghs sedimentation rate CPT 85651 | $67.47 | $173.00 | $6.22 – $14.77 | 4 |
| Ghs semen analysis fert CPT 89320 | $311.22 | $798.00 | $21.12 – $42.59 | 4 |
| Ghs semen analysis, post-vas CPT 89300 | $32.37 | $83.00 | $15.62 – $34.05 | 4 |
| Ghs sensitivity (per antimicro) CPT 87184 | $83.46 | $214.00 | $12.08 – $25.88 | 4 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $741.00 | $1,900.00 | $1,125.52 – $4,714.00 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $741.00 | $1,900.00 | $1,125.52 – $4,714.00 | 5 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $741.00 | $1,900.00 | $1,125.52 – $4,714.00 | 5 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $741.00 | $1,900.00 | $1,125.52 – $4,714.00 | 5 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $741.00 | $1,900.00 | $565.10 – $3,391.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $741.00 | $1,900.00 | $565.10 – $3,391.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $741.00 | $1,900.00 | $565.10 – $3,391.00 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $741.00 | $1,900.00 | $565.10 – $4,714.00 | 5 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $741.00 | $1,900.00 | $565.10 – $4,714.00 | 5 |
| Ghs sleep study unattended CPT 95800 | $430.95 | $1,105.00 | $440.91 – $440.91 | 1 |
| Ghs somatosensory testing lower extremit CPT 95926 | $2,308.02 | $5,918.00 | $885.97 – $885.97 | 1 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $3,985.41 | $10,219.00 | not published | 0 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $114.66 | $294.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $783.90 | $2,010.00 | $836.02 – $3,391.00 | 4 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $360.57 – $360.57 | 1 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $115.05 | $295.00 | not published | 0 |
| Ghs st - eval for alt comm CPT 92567 | $157.95 | $405.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $304.59 | $781.00 | $360.57 – $5,063.00 | 3 |
| Ghs st - re-eval for alt comm CPT 92597 | $193.44 | $496.00 | not published | 0 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $58.89 | $151.00 | not published | 0 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $266.37 | $683.00 | $605.00 – $605.00 | 1 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,579.89 | $4,051.00 | $1,308.00 – $3,391.00 | 5 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $1,232.79 | $3,161.00 | $1,125.52 – $3,391.00 | 5 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $3,304.08 | $8,472.00 | $1,308.00 – $5,272.00 | 5 |
| Ghs trypsin (fecal) CPT 84488 | $21.84 | $56.00 | $12.79 – $25.26 | 4 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $900.51 | $2,309.00 | $665.65 – $5,063.00 | 3 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $806.13 | $2,067.00 | $665.65 – $4,714.00 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | $157.56 | $404.00 | $42.59 – $84.08 | 4 |
| Ghs urine, porphyrins quant CPT 84120 | $207.48 | $532.00 | $25.76 – $50.90 | 4 |
| Ghs vaginal delivery only CPT 59409 | $5,171.40 | $13,260.00 | $3,391.00 – $8,824.63 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $2,176.59 | $5,581.00 | not published | 0 |
| Ghs windowing of cast CPT 29730 | $184.86 | $474.00 | $444.76 – $5,063.00 | 3 |
| Giardia ag if CPT 87269 | not published | not published | $21.02 – $47.09 | 4 |
| Giardia lamblia antibody CPT 86674 | $281.58 | $722.00 | $25.80 – $50.93 | 4 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $141.46 – $709.31 | 4 |
| Gi inhouse confirmation CPT 87045 | $134.16 | $344.00 | $16.52 – $32.66 | 4 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Gi protein loss CPT 78282 | not published | not published | $132.45 – $1,177.06 | 4 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,224.91 | $8,269.00 | $2,558.69 – $5,272.00 | 2 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $2,579.78 – $2,579.78 | 1 |
| Gi trc img intral esophagus CPT 91111 | $1,545.57 | $3,963.00 | $2,558.69 – $5,272.00 | 2 |
| Gi wireless capsule measure CPT 91112 | $1,049.49 | $2,691.00 | $2,558.69 – $5,272.00 | 2 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $121.34 – $349.88 | 3 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $73.82 – $212.86 | 3 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $42.00 – $144.28 | 3 |
| Glassia injection HCPCS J0257 | not published | not published | $10.50 – $18.51 | 3 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $84.05 – $84.05 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $2,323.00 – $11,476.46 | 5 |
| Glaucoma surgery CPT 66155 | not published | not published | $2,323.00 – $11,476.46 | 5 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,694.00 – $6,577.81 | 5 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,323.00 – $6,577.81 | 5 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $351.05 – $651.76 | 3 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $213.30 – $428.45 | 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.