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 |
|---|---|---|---|---|
| Imatinib 100 mg tab HCPCS S0088 | not published | not published | $5.78 – $5.78 | 1 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $102.22 – $102.22 | 1 |
| Img rta detcj/mntr ds staff CPT 92227 | $76.05 | $195.00 | $172.66 – $172.66 | 1 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $172.66 – $172.66 | 1 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $33.10 | $84.87 | not published | 0 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $1,694.00 – $18,406.78 | 5 |
| Immune complex assay CPT 86332 | $238.29 | $611.00 | $42.71 – $84.32 | 4 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | not published | not published | $88.55 – $152.76 | 3 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $155.21 – $271.61 | 3 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $93.97 – $155.63 | 3 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $202.97 – $202.97 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $140.79 | $361.00 | $36.46 – $72.00 | 4 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $140.01 | $359.00 | $36.46 – $72.00 | 4 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $34.37 – $88.47 | 4 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $121.68 | $312.00 | $21.00 – $41.45 | 4 |
| Immunodiffusion nes CPT 86329 | $63.57 | $163.00 | $24.61 – $48.61 | 4 |
| Immunoelectrophoresis assay CPT 86327 | not published | not published | $39.76 – $103.52 | 4 |
| Immunofixation electrophoresis serum CPT 86334 | $133.38 | $342.00 | $39.14 – $77.30 | 4 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $154.05 | $395.00 | $52.45 – $100.50 | 3 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $321.36 | $824.00 | $41.46 – $482.12 | 4 |
| Immunoglobulin assay CPT 86023 | $169.26 | $434.00 | $21.83 – $43.11 | 4 |
| Immunology procedure CPT 86849 | not published | not published | $28.70 – $28.70 | 1 |
| Impact tooth remov part bony HCPCS D7230 | not published | not published | $2,485.25 – $5,063.00 | 2 |
| Impedence cardiogram CPT 93701 | not published | not published | $360.57 – $360.57 | 1 |
| Imp extar knee shck absrb HCPCS C8003 | not published | not published | $6,389.00 – $16,710.00 | 2 |
| Impl absrb msh/prsth dly cls CPT 15778 | not published | not published | $5,809.00 – $6,859.00 | 2 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $1,655.47 | $4,244.79 | not published | 0 |
| Implantation iris prosthesis CPT 66683 | not published | not published | $6,760.00 – $11,889.00 | 2 |
| Implant biventricular device 33976 CPT 33976 | $5,053.23 | $12,957.00 | $5,063.00 – $6,859.00 | 2 |
| Implant brain electrodes CPT 61531 | not published | not published | $5,063.00 – $5,272.00 | 2 |
| Implant brain electrodes CPT 61533 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant brain electrodes CPT 61760 | not published | not published | $5,063.00 – $5,272.00 | 2 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $188,363.27 | $482,982.75 | not published | 0 |
| Implant cochlear device CPT 69930 | not published | not published | $3,721.00 – $94,656.30 | 5 |
| Implant cochlear osia osi300 HCPCS L8690 | $20,236.19 | $51,887.66 | not published | 0 |
| Implant eye drug system CPT 67027 | not published | not published | $2,323.00 – $44,551.45 | 5 |
| Implant hormone pellet(s) 11980 CPT 11980 | $244.14 | $626.00 | $1,124.66 – $3,391.00 | 3 |
| Implant nerve end CPT 64787 | not published | not published | $1,694.00 – $4,714.00 | 3 |
| Implant neuroelectrde addl CPT 61864 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant neuroelectrde addl CPT 61868 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant neuroelectrode CPT 61863 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant neuroelectrode CPT 61867 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $8,245.00 – $61,747.09 | 3 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $1,308.00 – $38,450.25 | 5 |
| Implant neuroelectrodes CPT 64555 | $382.20 | $980.00 | $3,391.00 – $19,304.54 | 3 |
| Implant neuroelectrodes CPT 64561 | $4,518.54 | $11,586.00 | $1,937.00 – $19,304.54 | 5 |
| Implant neuroelectrodes CPT 61850 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant neuroelectrodes CPT 61860 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant neurostim arrays CPT 61886 | not published | not published | $1,937.00 – $87,649.64 | 5 |
| Implant open hernia repair w/mesh 49568 CPT 49568 | not published | not published | $3,721.00 – $5,063.00 | 2 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | $8,391.88 | $21,517.65 | not published | 0 |
| Implant pulse generator remede el HCPCS C1823 | $65,976.59 | $169,170.75 | not published | 0 |
| Implant/replace hearing aid CPT 69710 | not published | not published | $1,937.00 – $11,889.00 | 4 |
| Implant single ventricular device 33975 CPT 33975 | $5,053.23 | $12,957.00 | $5,063.00 – $6,859.00 | 2 |
| Implant spinal canal cath CPT 62351 | not published | not published | $1,694.00 – $20,193.44 | 5 |
| Implant spine infusion pump CPT 62361 | not published | not published | $1,694.00 – $56,095.00 | 5 |
| Implant spine infusion pump CPT 62362 | not published | not published | $1,694.00 – $56,095.00 | 5 |
| Implant tcat pulm vlv perq CPT 33477 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant ureter in bowel CPT 50800 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implant ureth bulk agent HCPCS L8606 | $2,168.00 | $5,558.98 | not published | 0 |
| Impl ear abutment ba300 9mm HCPCS L8693 | $5,492.46 | $14,083.24 | not published | 0 |
| Impl neurostim electr perc CPT 63650 | $9,060.48 | $23,232.00 | $1,694.00 – $19,304.54 | 5 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Implnt spinl canal catheter 62350 CPT 62350 | not published | not published | $1,694.00 – $18,802.95 | 5 |
| Impl oi implt sk tc esp<100 CPT 69716 | not published | not published | $10,437.00 – $37,149.33 | 3 |
| Impl oi implt sk tc esp>=100 CPT 69729 | not published | not published | $10,437.00 – $37,149.33 | 3 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $7,487.00 – $37,149.33 | 4 |
| Impl/rplcmt gstr nstim eltrd CPT 43881 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implt brain chemotx add-on 61517 CPT 61517 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Impltj ntrstrml crnl rng seg CPT 65785 | not published | not published | $6,389.00 – $11,889.00 | 3 |
| Impltj tot rplcmt hrt sys CPT 33927 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Implt neurostim elctr each HCPCS L8680 | $3,535.57 | $9,065.56 | not published | 0 |
| Imported lipodox inj HCPCS Q2049 | not published | not published | $824.26 – $1,171.46 | 3 |
| Impres&prep auricular prosth CPT 21086 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep def obt prosth CPT 21080 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep facial prosth CPT 21088 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep intrm obt prosth CPT 21079 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep mndbl res prosth CPT 21081 | not published | not published | $5,063.00 – $16,529.94 | 3 |
| Impres&prep nasal prosth CPT 21087 | not published | not published | $5,063.00 – $16,529.94 | 3 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $689.46 – $5,063.00 | 3 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $5,063.00 – $16,529.94 | 3 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $5,063.00 – $11,889.00 | 3 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $4,304.67 – $5,272.00 | 3 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $82.68 – $152.31 | 3 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $8,184.67 – $8,184.67 | 1 |
| In-111 autol wbc diag per dose HCPCS A9570 | $3,785.34 | $9,706.00 | $8,184.67 – $8,184.67 | 1 |
| In-111 capromab pendet HCPCS A9507 | $3,941.34 | $10,106.00 | $8,546.37 – $8,546.37 | 1 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $6,450.13 – $6,450.13 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $1,671.54 | $4,286.00 | $4,092.33 – $4,092.33 | 1 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $1,811.16 | $4,644.00 | $1,721.52 – $1,721.52 | 1 |
| In-111 pentetreotide HCPCS A9572 | $4,194.84 | $10,756.00 | not published | 0 |
| In-111 satumomab pend HCPCS A4642 | $5,837.52 | $14,968.00 | $2,630.47 – $2,630.47 | 1 |
| Inactivated je vacc im CPT 90738 | not published | not published | $613.94 – $613.94 | 1 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $1,937.00 – $11,889.00 | 3 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $1,694.00 – $20,193.44 | 5 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $6,760.00 – $15,026.00 | 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.