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 |
|---|---|---|---|---|
| Io anal gast n-stim subsq CPT 95981 | $187.20 | $480.00 | $172.66 – $172.66 | 1 |
| Iodine i-123 sod iodide mil HCPCS A9509 | not published | not published | $290.36 – $290.36 | 1 |
| Iodine i-125 sodium iodide HCPCS A9527 | not published | not published | $106.98 – $333.32 | 3 |
| Iodine i-131 iobenguane 1mci HCPCS A9590 | not published | not published | $622.88 – $1,016.41 | 3 |
| Io ga n-stim subsq w/reprog CPT 95982 | $305.76 | $784.00 | not published | 0 |
| Ionm in operatng room 15 min CPT 95940 | $286.26 | $734.00 | not published | 0 |
| Ionm remote/>1 pt or per hr CPT 95941 | $448.11 | $1,149.00 | not published | 0 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $257.40 | $660.00 | $0.78 – $0.78 | 1 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $321.75 | $825.00 | $0.27 – $0.27 | 1 |
| Io rad tx deliver by elctrns CPT 77425 | $9,332.31 | $23,929.00 | $16,164.85 – $21,980.75 | 2 |
| Io rad tx delivery by x-ray CPT 77424 | $11,887.20 | $30,480.00 | $10,789.00 – $21,980.75 | 3 |
| Ioxaglate 39.3%-19.6% inj 200 ml HCPCS Q9964 | not published | not published | $0.55 – $0.55 | 1 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | not published | not published | $343.18 – $596.57 | 3 |
| Ipratropium bromide comp HCPCS J7645 | not published | not published | $0.10 – $0.10 | 1 |
| Ipratropium bromide non-comp HCPCS J7644 | not published | not published | $0.71 – $0.71 | 1 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | not published | not published | $3.75 – $3.75 | 1 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | not published | not published | $122.40 – $214.59 | 3 |
| Iron CPT 83540 | $130.65 | $335.00 | $11.35 – $22.39 | 4 |
| Iron binding capacity CPT 83550 | $143.52 | $368.00 | $15.32 – $30.24 | 4 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | not published | not published | $33.16 – $59.93 | 3 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $11.34 – $23.80 | 4 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | not published | not published | $0.44 – $0.44 | 1 |
| Irradiation of blood product each unit reference CPT 86945 | $241.02 | $618.00 | $17.39 – $113.20 | 4 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $329.16 | $844.00 | $72.76 – $172.66 | 2 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $2,572.00 – $5,272.00 | 4 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $172.66 – $5,063.00 | 3 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $151.24 – $264.69 | 3 |
| Island pedicle flap graft CPT 15740 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Ivc venogram s&i CPT 75825 | $1,994.85 | $5,115.00 | $182.22 – $8,997.17 | 4 |
| IV Fluids (each additional hour) CPT 96361 | $110.76 | $284.00 | not published | 0 |
| IV Fluids (first hour) CPT 96360 | $427.05 | $1,095.00 | $605.00 – $605.00 | 1 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $289.67 – $289.67 | 1 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $427.05 | $1,095.00 | not published | 0 |
| IV inj ra drug dx study CPT 78808 | $281.19 | $721.00 | $722.13 – $1,164.18 | 2 |
| IV Medicine Infusion (additional drug) CPT 96367 | $427.05 | $1,095.00 | $198.84 – $198.84 | 1 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $106.47 | $272.99 | not published | 0 |
| IV Medicine Infusion (first hour) CPT 96365 | $427.05 | $1,095.00 | $605.00 – $605.00 | 1 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $1,124.66 – $3,391.00 | 3 |
| IV Push Injection (each additional drug) CPT 96375 | $191.88 | $492.00 | not published | 0 |
| IV Push Injection (first drug) CPT 96374 | $306.54 | $786.00 | $605.00 – $605.00 | 1 |
| Ivp w/nephrotomography CPT 74415 | $862.29 | $2,211.00 | $257.38 – $542.48 | 4 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $645.84 | $1,656.00 | $196.91 – $518.62 | 4 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $260.04 – $443.12 | 3 |
| Jak2 targeted sequence analysis CPT 81279 | $601.77 | $1,543.00 | $222.24 – $640.79 | 2 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $271.44 | $696.00 | $81.72 – $256.49 | 4 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $384.93 | $987.00 | $58.02 – $310.32 | 4 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $1,694.00 – $5,371.00 | 5 |
| John cunningham antibody CPT 86711 | $1,727.70 | $4,430.00 | $23.75 – $58.44 | 4 |
| J-tube placement CPT 44015 | not published | not published | $1,308.00 – $6,859.00 | 3 |
| Keratomileusis CPT 65760 | not published | not published | $6,179.00 – $9,000.00 | 2 |
| Keratophakia CPT 65765 | not published | not published | $6,179.00 – $9,000.00 | 2 |
| Keratoprosthesis CPT 65770 | not published | not published | $3,721.00 – $34,992.95 | 4 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $1,100.72 – $1,100.72 | 1 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $25.87 – $25.87 | 1 |
| Ketogenic steroids fract CPT 83582 | $81.12 | $208.00 | $24.83 – $53.53 | 4 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $178.62 | $458.00 | $14.32 – $28.27 | 4 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | not published | not published | $1.43 – $1.43 | 1 |
| Kidney endoscopy CPT 50551 | not published | not published | $1,308.00 – $14,605.40 | 5 |
| Kidney endoscopy CPT 50553 | not published | not published | $1,308.00 – $14,605.40 | 5 |
| Kidney endoscopy CPT 50570 | not published | not published | $1,308.00 – $9,840.21 | 5 |
| Kidney endoscopy CPT 50575 | not published | not published | $5,063.00 – $14,605.40 | 3 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $1,308.00 – $26,003.15 | 5 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $1,308.00 – $9,840.21 | 5 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $1,308.00 – $26,003.15 | 5 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $1,308.00 – $14,605.40 | 5 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $1,308.00 – $26,003.15 | 4 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $1,308.00 – $14,605.40 | 4 |
| Kidney function study CPT 78725 | not published | not published | $211.64 – $1,164.18 | 4 |
| Kidney imaging (3d) CPT 78710 | not published | not published | $408.55 – $830.76 | 2 |
| Kidney imaging morphology CPT 78700 | $553.80 | $1,420.00 | $357.90 – $1,164.18 | 4 |
| Kidney imag w/bld flow multi CPT 78709 | not published | not published | $711.68 – $1,525.66 | 4 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $824.46 | $2,114.00 | $446.95 – $1,525.66 | 4 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $618.54 | $1,586.00 | $177.31 – $455.16 | 4 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $290.16 | $744.00 | $68.65 – $380.34 | 4 |
| Kit case 4.2mm spinejack HCPCS C1062 | $7,751.14 | $19,874.72 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $8,081.88 | $20,722.77 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $170.43 | $437.00 | $149.84 – $432.05 | 4 |
| Kit hfx iq ipg bundle HCPCS C1822 | $42,421.35 | $108,772.69 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $49,011.18 | $125,669.70 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $16,965.41 | $43,501.05 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,340.86 | $3,438.11 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $57.71 – $57.71 | 1 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $16,851.58 | $43,209.18 | not published | 0 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,638.82 | $4,202.10 | not published | 0 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $2,323.00 – $8,448.00 | 5 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $2,323.00 – $11,889.00 | 5 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $1,937.00 – $9,136.47 | 5 |
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.