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 |
|---|---|---|---|---|
| Glucagon plasma - sendout CPT 82943 | $205.92 | $528.00 | $25.03 – $49.44 | 4 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $80.71 – $165.85 | 4 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $82.86 – $174.73 | 4 |
| Glucagon tolerance test CPT 82946 | not published | not published | $26.41 – $61.48 | 4 |
| Glucose 1 hr post dose CPT 82950 | $77.61 | $199.00 | $8.32 – $16.43 | 4 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $10.61 – $20.93 | 4 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $5.46 | $14.00 | $4.01 – $11.35 | 4 |
| Glucose blood quantitative CPT 82947 | $83.85 | $215.00 | $6.88 – $13.60 | 4 |
| Glucose body fluid CPT 82945 | $140.01 | $359.00 | $6.88 – $13.60 | 4 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $73.32 | $188.00 | $172.66 – $172.66 | 1 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $189.54 | $486.00 | $22.56 – $44.53 | 4 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $48.36 | $124.00 | $6.86 – $13.56 | 4 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $1.11 – $1.11 | 1 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $57.47 – $57.47 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $20.09 – $42.70 | 3 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $219.18 | $562.00 | $32.57 – $64.29 | 4 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $229.43 – $513.50 | 4 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $253.11 | $649.00 | $32.45 – $64.08 | 4 |
| Gonioscopy CPT 92020 | $145.86 | $374.00 | $360.57 – $360.57 | 1 |
| Goniotomy CPT 65820 | not published | not published | $1,308.00 – $11,476.46 | 5 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $1,340.03 – $2,107.17 | 3 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $58.09 – $58.09 | 1 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $2,210.22 – $2,210.22 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $17,618.72 | $45,176.20 | $143.83 – $143.83 | 1 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $59.30 – $59.30 | 1 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $1,454.05 – $1,454.05 | 1 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $24,646.06 | $63,195.03 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $44,279.60 | $113,537.43 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $124.67 – $124.67 | 1 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,413.85 | $3,625.26 | $201.45 – $201.45 | 1 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $5,089.62 | $13,050.32 | $264.46 – $264.46 | 1 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $208.78 | $535.34 | $92.35 – $92.35 | 1 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $308.92 – $308.92 | 1 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $260.84 – $260.84 | 1 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $55,695.63 | $142,809.30 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $25,834.81 | $66,243.10 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $5.83 – $5.83 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.44 – $0.44 | 1 |
| Granulocyte pheresis ea unit HCPCS P9050 | $1,967.55 | $5,045.00 | not published | 0 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,323.00 – $11,889.00 | 3 |
| Great toe with reduction 28495 CPT 28495 | $900.51 | $2,309.00 | $665.65 – $3,391.00 | 3 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $4,714.00 – $9,032.00 | 4 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $6,389.00 – $10,126.62 | 4 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Grfg autol soft tiss dir exc CPT 15769 | $4,128.93 | $10,587.00 | $6,389.00 – $10,126.62 | 4 |
| Ground mileage HCPCS A0425 | $17.55 | $45.00 | $31.21 – $31.21 | 1 |
| Growth hormone antibody CPT 86277 | not published | not published | $27.58 – $54.46 | 4 |
| Growth hormone panel CPT 80428 | not published | not published | $116.83 – $254.10 | 4 |
| Growth hormone panel CPT 80430 | not published | not published | $126.96 – $447.48 | 4 |
| Growth stimulation gene 2 CPT 83006 | $223.47 | $573.00 | $35.92 – $261.58 | 4 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $5,063.00 – $11,889.00 | 2 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $5,063.00 – $6,179.00 | 3 |
| G-tube reposition CPT 43761 | $4,334.85 | $11,115.00 | $697.61 – $3,391.00 | 5 |
| Gu dilat ureter/urethra s&i CPT 74485 | $821.73 | $2,107.00 | $151.16 – $5,749.22 | 4 |
| Guided cath fluid drainage 10030 CPT 10030 | $7,100.34 | $18,206.00 | $1,985.95 – $4,714.00 | 3 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,531.94 | $9,056.25 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $945.75 | $2,425.00 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $1,051.44 | $2,696.00 | $89.89 – $173.38 | 3 |
| Gum graft CPT 41870 | not published | not published | $4,304.67 – $5,272.00 | 3 |
| Gw stiffened micro access kit HCPCS C1894 | $13,326.50 | $34,170.52 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $2,323.00 – $10,759.21 | 5 |
| Hair analysis HCPCS P2031 | not published | not published | $7.33 – $7.33 | 1 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $1,772.77 – $5,063.00 | 3 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $1,125.52 – $5,809.00 | 5 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $1,125.52 – $5,809.00 | 5 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $10.58 – $10.58 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $2.31 – $2.31 | 1 |
| Hand-held pefr meter a4614 HCPCS A4614 | $33.10 | $84.87 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $7.36 – $7.36 | 1 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $6,104.40 | $15,652.30 | not published | 0 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $97.50 | $250.00 | not published | 0 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Hand X-ray CPT 73130 | $264.42 | $678.00 | $50.67 – $256.49 | 4 |
| Hand X-ray (2 views, both hands) CPT 73120 | $237.90 | $610.00 | $40.86 – $310.32 | 4 |
| Haptoglobin quantitative CPT 83010 | $235.17 | $603.00 | $22.04 – $43.53 | 4 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $2,665.00 – $5,063.00 | 2 |
| Harvest auto stem cells CPT 38206 | $4,212.00 | $10,800.00 | $4,330.86 – $5,272.00 | 3 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,694.00 – $6,595.97 | 5 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $2,665.00 – $5,063.00 | 2 |
| Harvest stem cell concentrte CPT 38215 | $1,287.78 | $3,302.00 | $1,225.32 – $5,063.00 | 4 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $2,665.00 – $5,063.00 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $360.57 – $360.57 | 1 |
| Hast w/oxygen titrate CPT 94453 | $154.05 | $395.00 | $360.57 – $360.57 | 1 |
| Hba1/hba2 full gene sequence CPT 81259 | $847.86 | $2,174.00 | $720.00 – $2,076.00 | 4 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $190.32 | $488.00 | $242.88 – $700.30 | 4 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $450.30 – $1,298.36 | 4 |
| Hbb full gene sequence CPT 81364 | $459.42 | $1,178.00 | $389.50 – $1,123.05 | 4 |
| Hbb gene com variants CPT 81361 | $228.54 | $586.00 | $209.77 – $604.84 | 4 |
| Hbb gene dup/del variants CPT 81363 | $228.54 | $586.00 | $242.88 – $700.30 | 4 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $450.30 – $1,298.36 | 4 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $17.00 – $33.60 | 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.