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 |
|---|---|---|---|---|
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $0.97 – $0.97 | 1 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | not published | not published | $0.71 – $0.71 | 1 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | not published | not published | $7.78 – $7.78 | 1 |
| Hydrocortisone acetate inj HCPCS J1700 | not published | not published | $1.24 – $1.24 | 1 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | not published | not published | $39.91 – $39.91 | 1 |
| Hydrocortisone sodium ph inj HCPCS J1710 | not published | not published | $8.92 – $8.92 | 1 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | not published | not published | $0.17 – $0.17 | 1 |
| Hydromorphone 250 mg HCPCS S0092 | not published | not published | $162.18 – $162.18 | 1 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.02 – $0.02 | 1 |
| Hydroxyurea 500 mg HCPCS S0176 | not published | not published | $1.09 – $1.09 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | not published | not published | $23.46 – $23.46 | 1 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | not published | not published | $0.19 – $0.19 | 1 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $244.92 | $628.00 | $30.68 – $61.93 | 4 |
| Hymenotomy CPT 56442 | not published | not published | $1,308.00 – $8,824.63 | 5 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $33.20 – $83.93 | 3 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $2,572.00 – $16,529.94 | 4 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $104.98 – $104.98 | 1 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $17.82 – $35.22 | 4 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $1,568.74 – $4,806.67 | 4 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $758.58 – $1,624.37 | 4 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $870.18 – $2,346.17 | 4 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $1,661.58 – $4,664.77 | 4 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $1,661.58 – $4,195.07 | 4 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $33.72 – $59.13 | 3 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $5,063.00 – $8,448.00 | 2 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $5,063.00 – $8,448.00 | 2 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $6,859.00 – $9,000.00 | 2 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| Hysterosalpingography s&i CPT 74740 | $321.36 | $824.00 | $128.28 – $691.66 | 4 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $2,323.00 – $14,039.62 | 5 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $1,937.00 – $8,824.63 | 5 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $1,308.00 – $8,824.63 | 5 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $1,694.00 – $14,039.62 | 5 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $1,937.00 – $8,824.63 | 5 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $1,937.00 – $14,039.62 | 5 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $1,937.00 – $14,039.62 | 5 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $4,220.00 – $14,039.62 | 4 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | not published | not published | $422.46 – $422.46 | 1 |
| I-123 iobenguane diag HCPCS A9582 | $3,423.81 | $8,779.00 | $9,931.37 – $9,931.37 | 1 |
| I-123 ioflupane diag HCPCS A9584 | $2,667.99 | $6,841.00 | $4,798.09 – $4,798.09 | 1 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $123.24 | $316.00 | $186.31 – $186.31 | 1 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $72.90 – $72.90 | 1 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $332.27 – $332.27 | 1 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $2,463.63 | $6,317.00 | $1,582.78 – $1,582.78 | 1 |
| I131 iodide cap, rx HCPCS A9517 | $387.62 | $993.89 | $53.32 – $127.36 | 3 |
| I131 iodide sol, rx HCPCS A9530 | not published | not published | $17.82 – $61.05 | 3 |
| I131 max 100uci HCPCS A9531 | $57.72 | $148.00 | $6.80 – $6.80 | 1 |
| I131 serum albumin, dx HCPCS A9524 | $2,970.37 | $7,616.34 | $153.91 – $153.91 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | $46.02 | $118.00 | $21.02 – $46.43 | 4 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $243.75 | $625.00 | $61.50 – $121.41 | 4 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $22.69 – $62.59 | 4 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $186.42 | $478.00 | $54.34 – $156.67 | 2 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $48.34 – $48.34 | 1 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $8,472.02 – $8,472.02 | 1 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $5.66 – $5.66 | 1 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $592.02 – $837.93 | 3 |
| Icatibant injection HCPCS J1744 | not published | not published | $181.18 – $559.60 | 3 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $24,213.35 | $62,085.51 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $43,666.45 | $111,965.26 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $14,360.25 | $36,821.16 | not published | 0 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $9,069.61 | $23,255.42 | not published | 0 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $885.97 – $885.97 | 1 |
| Icut allergy test drug/bug CPT 95024 | $87.75 | $225.00 | $172.66 – $172.66 | 1 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $84.05 – $84.05 | 1 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $1,308.00 – $9,087.85 | 5 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $89.20 – $89.20 | 1 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $4,576.34 – $5,272.00 | 3 |
| Idecabtagene vicleucel car HCPCS Q2055 | $1,129,895.40 | $2,897,167.68 | $0.03 – $1,178,375.50 | 2 |
| Identify sperm tissue CPT 89264 | not published | not published | $65.18 – $236.25 | 3 |
| Idet 1 or more levels CPT 22527 | not published | not published | $5,809.00 – $9,032.00 | 3 |
| Idet single level CPT 22526 | $368.55 | $945.00 | $5,809.00 – $9,032.00 | 3 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $1,308.00 – $9,136.47 | 5 |
| Idh1 common variants CPT 81120 | $263.64 | $676.00 | $231.90 – $668.64 | 4 |
| Idh2 common variants CPT 81121 | $415.35 | $1,065.00 | $354.95 – $1,023.43 | 4 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $1,694.00 – $7,925.42 | 5 |
| I&d lacrimal gland CPT 68400 | not published | not published | $2,572.00 – $5,272.00 | 4 |
| I&d lacrimal sac CPT 68420 | $2,552.94 | $6,546.00 | $1,937.00 – $6,595.97 | 5 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $6,765.72 | $17,348.00 | $1,308.00 – $8,020.55 | 5 |
| Idursulfase injection HCPCS J1743 | not published | not published | $1,033.47 – $1,878.50 | 2 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $1,308.00 – $8,020.55 | 5 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $4,714.00 – $8,020.55 | 3 |
| Ifnl3 gene CPT 81283 | not published | not published | $90.53 – $253.86 | 4 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $47.78 – $47.78 | 1 |
| Igh@/bcl2 translocation alys CPT 81278 | $351.00 | $900.00 | $248.77 – $717.29 | 2 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $71.46 – $237.18 | 4 |
| Igh gene rearrange amp meth CPT 81261 | $1,030.77 | $2,643.00 | $324.13 – $685.05 | 4 |
| Igh@ var region somatic mutation analy CPT 81263 | $3,531.06 | $9,054.00 | $482.15 – $1,019.04 | 4 |
| Igk rearrangeabn clonal pop CPT 81264 | $399.36 | $1,024.00 | $244.46 – $597.65 | 4 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $220.74 | $566.00 | $54.56 – $142.16 | 3 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $232.83 | $597.00 | $92.36 – $1,014.60 | 4 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $481.65 | $1,235.00 | $41.46 – $482.12 | 4 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | not published | not published | $26.66 – $32.09 | 2 |
| Ikbkap gene CPT 81260 | not published | not published | $47.17 – $136.01 | 3 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $6,389.00 – $15,026.00 | 2 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,856.01 | $4,759.00 | not published | 0 |
| Iliac revasc add-on 37222 CPT 37222 | $5,370.69 | $13,771.00 | $3,391.00 – $15,026.00 | 2 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $282.55 – $282.55 | 1 |
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.