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 |
|---|---|---|---|---|
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $42.19 – $54.32 | 2 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Infuse radioactive materials CPT 77750 | $1,240.98 | $3,182.00 | $263.13 – $758.58 | 4 |
| Ingest challenge ea addl 60 min CPT 95079 | $189.54 | $486.00 | not published | 0 |
| Ingest challenge ini 120 min CPT 95076 | $854.88 | $2,192.00 | not published | 0 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $697.32 | $1,788.00 | $602.04 – $602.04 | 1 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $11.28 – $20.34 | 2 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $13.48 – $23.56 | 3 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.46 – $0.46 | 1 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.10 – $0.21 | 2 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.08 – $0.17 | 2 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.10 – $0.17 | 2 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $7,295.84 – $14,169.81 | 2 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $25.22 – $25.22 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $114,360.00 – $213,828.00 | 2 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $11.40 – $20.69 | 3 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $65.89 – $65.89 | 1 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $627.19 – $627.19 | 1 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $2.90 – $4.98 | 3 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $4.90 – $4.90 | 1 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $8.39 – $19.20 | 2 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $279.97 – $279.97 | 1 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $110.99 – $209.61 | 2 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $18.55 – $27.10 | 2 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $243.02 – $761.53 | 3 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $33.85 – $59.44 | 3 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $6,611.63 – $11,587.51 | 2 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $3.62 – $5.58 | 2 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $5.97 – $10.69 | 3 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $88.02 – $155.12 | 2 |
| Inj. asceniv HCPCS J1554 | not published | not published | $943.41 – $1,700.28 | 3 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $103.19 – $176.32 | 3 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $207.18 – $207.18 | 1 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $148.40 – $263.03 | 3 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $85.81 – $140.01 | 3 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $316.19 – $586.47 | 3 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $77.82 – $77.82 | 1 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $75.99 – $137.92 | 3 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $400.05 – $713.49 | 3 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.32 – $0.62 | 2 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $89.05 – $145.29 | 2 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $15.08 – $89.05 | 2 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $2.74 – $5.26 | 2 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $144.84 – $215.49 | 3 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $817.03 – $817.03 | 1 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $3,268.08 – $3,268.08 | 1 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $645.92 – $1,125.33 | 3 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $2.76 – $2.76 | 1 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.93 – $1.50 | 2 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $322.50 – $648.78 | 2 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $1.93 – $1.93 | 1 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $63.66 – $476.31 | 2 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $2.34 – $4.26 | 2 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $1.91 – $1.91 | 1 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $2.12 – $2.12 | 1 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $10.94 – $19.51 | 2 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $9.38 – $18.23 | 2 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $4.35 – $7.51 | 3 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $15.53 – $25.50 | 3 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $215.53 – $215.53 | 1 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $29.98 – $52.14 | 3 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $321.62 – $906.80 | 2 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $170.36 – $170.36 | 1 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $6.65 – $6.65 | 1 |
| Inj, clindamycin (baxter) HCPCS J0737 | not published | not published | $4.97 – $6.06 | 2 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $409.11 | $1,049.00 | $2,665.00 – $3,391.00 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $170.22 – $277.78 | 3 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,957.79 – $3,155.80 | 3 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $1,011.51 – $1,011.51 | 1 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $27.66 – $48.06 | 2 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $31.66 – $55.08 | 3 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $9.42 – $9.42 | 1 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $13.01 – $17.02 | 2 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $1.33 – $9.96 | 3 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $4.17 – $4.17 | 1 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $8.29 – $12.98 | 2 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.13 – $0.13 | 1 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.08 – $0.24 | 2 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.08 – $0.08 | 1 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $8.16 – $9.34 | 2 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $2.70 – $3.89 | 2 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $0.03 – $0.03 | 1 |
| Inj diclofenac sodium 0.5mg HCPCS J1130 | not published | not published | $0.40 – $0.40 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $7.80 – $7.80 | 1 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $836.02 – $3,391.00 | 3 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $12.77 – $47.01 | 3 |
| Inj dx for sinogram CPT 20501 | $697.71 | $1,789.00 | $2,665.00 – $3,391.00 | 2 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,807.65 | $4,635.00 | $1,952.00 – $4,066.00 | 4 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $764.40 | $1,960.00 | $2,665.00 – $3,391.00 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $95.83 – $169.12 | 3 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $895.31 – $1,534.51 | 3 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $37.11 – $56.34 | 3 |
| Injection, caplacizumab-yhdp HCPCS C9047 | not published | not published | $1,456.68 – $2,306.54 | 3 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $1,832.61 | $4,699.00 | $836.02 – $3,391.00 | 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.