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 |
|---|---|---|---|---|
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $6,389.00 – $16,529.94 | 3 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $6,389.00 – $16,529.94 | 3 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $6,389.00 – $16,529.94 | 3 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $708.63 | $1,817.00 | $507.40 – $999.13 | 3 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,269.45 | $3,255.00 | $385.65 – $518.62 | 3 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $1,167.27 | $2,993.00 | $298.22 – $343.51 | 3 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $35.12 – $69.37 | 4 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $73.14 – $144.49 | 4 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $5,063.00 – $8,997.17 | 3 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $984.75 | $2,525.00 | $375.04 – $729.59 | 3 |
| Leishmania antibody CPT 86717 | $58.50 | $150.00 | $21.47 – $42.38 | 4 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $1,308.00 – $9,136.47 | 5 |
| Lengthening of palate CPT 42227 | not published | not published | $5,063.00 – $16,529.94 | 3 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $2,664.00 – $16,529.94 | 5 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $1,694.00 – $20,193.44 | 5 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $1,937.00 – $11,889.00 | 5 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $2,323.00 – $15,026.00 | 3 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $2,323.00 – $37,149.33 | 5 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $200.91 | $515.16 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $977.16 | $2,505.55 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $683.72 | $1,753.14 | not published | 0 |
| Lepirudin HCPCS J1945 | not published | not published | $1,087.45 – $1,087.45 | 1 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | not published | not published | $7.93 – $7.93 | 1 |
| Leukacyte transfusion CPT 86950 | not published | not published | $17.39 – $482.12 | 4 |
| Leukocyte phagocytosis CPT 86344 | $218.40 | $560.00 | $13.99 – $35.95 | 4 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | not published | not published | $344.59 – $627.30 | 3 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $3,176.88 – $5,413.52 | 3 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $9,186.58 – $9,186.58 | 1 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $16.98 – $47.58 | 2 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $448.44 – $1,229.27 | 2 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $106.56 – $206.91 | 2 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $2.74 – $2.74 | 1 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.55 – $0.55 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.17 – $0.17 | 1 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | not published | not published | $0.10 – $0.10 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $155.61 | $399.00 | $21.71 – $45.84 | 4 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $3.60 – $3.60 | 1 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $609.01 – $609.01 | 1 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | not published | not published | $10.27 – $10.27 | 1 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $4,048.20 | $10,380.00 | $9,000.00 – $11,889.00 | 3 |
| Liberta rc ipg HCPCS C1820 | $65,883.98 | $168,933.29 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | not published | not published | $0.02 – $0.02 | 1 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | not published | $0.02 – $0.02 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | $112.71 | $289.00 | $25.74 – $50.83 | 4 |
| Ligate esophagus veins CPT 43400 | not published | not published | $5,063.00 – $15,026.00 | 2 |
| Ligate leg veins open CPT 37761 | not published | not published | $3,437.00 – $8,997.17 | 4 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $1,937.00 – $8,997.17 | 5 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $3,391.00 – $6,859.00 | 2 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $1,937.00 – $8,997.17 | 5 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $1,937.00 – $8,997.17 | 5 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $1,308.00 – $8,824.63 | 5 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $5,706.09 | $14,631.00 | $1,694.00 – $5,272.00 | 5 |
| Ligation common iliac vein CPT 37660 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $1,694.00 – $8,997.17 | 5 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $5,063.00 – $8,997.17 | 3 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $5,063.00 – $8,997.17 | 3 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $4,066.00 – $8,997.17 | 3 |
| Ligation major artery chest CPT 37616 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ligation major artery neck CPT 37615 | not published | not published | $4,066.00 – $8,997.17 | 3 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $1,694.00 – $8,997.17 | 5 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $5,063.00 – $8,448.00 | 2 |
| Ligation of femoral vein CPT 37650 | not published | not published | $1,694.00 – $8,997.17 | 5 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $5,809.00 – $15,511.46 | 3 |
| Ligation of neck artery CPT 37606 | not published | not published | $5,063.00 – $8,997.17 | 3 |
| Ligation of salivary duct CPT 42665 | not published | not published | $3,721.00 – $9,087.85 | 5 |
| Ligation of shunt CPT 49428 | not published | not published | $5,063.00 – $5,272.00 | 2 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $1,937.00 – $8,997.17 | 5 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $1,937.00 – $8,997.17 | 5 |
| Lig/band angioaccess av fistula CPT 37607 | $2,246.40 | $5,760.00 | $1,937.00 – $8,997.17 | 5 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $1,937.00 – $8,997.17 | 5 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $1,725.14 – $1,725.14 | 1 |
| Limb exercise test CPT 95875 | not published | not published | $440.91 – $440.91 | 1 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $1,694.00 – $4,714.00 | 3 |
| Limited autopsy CPT 88036 | not published | not published | $118.15 – $164.99 | 3 |
| Limited autopsy CPT 88037 | not published | not published | $94.36 – $146.96 | 3 |
| Limited visual field xm CPT 92081 | $73.32 | $188.00 | $172.66 – $172.66 | 1 |
| Lincomycin injection HCPCS J2010 | not published | not published | $12.83 – $12.83 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | not published | not published | $5.68 – $5.68 | 1 |
| Lipase CPT 83690 | $143.13 | $367.00 | $12.07 – $23.84 | 4 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $1,694.00 – $9,087.85 | 5 |
| Lipoprotein blood high res frac & quant CPT 83701 | $143.13 | $367.00 | $43.49 – $117.16 | 4 |
| Lipoprotein blood quant CPT 83704 | $198.51 | $509.00 | $55.28 – $118.30 | 4 |
| Lipoprotein direct measurement hdl CPT 83718 | $90.48 | $232.00 | $14.35 – $28.34 | 4 |
| Lipoprotein direct measurement ldl CPT 83721 | $96.72 | $248.00 | $16.72 – $36.33 | 4 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $83.85 | $215.00 | $42.07 – $118.30 | 3 |
| Lip surgery procedure CPT 40799 | not published | not published | $689.46 – $5,063.00 | 3 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $0.03 – $1,152,532.70 | 2 |
| Listeria monocytogenes CPT 86723 | $60.84 | $156.00 | $23.10 – $45.64 | 4 |
| Lithium therapeutic drug level CPT 80178 | $69.42 | $178.00 | $11.58 – $22.87 | 4 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,371.12 | $11,208.00 | $3,391.00 – $3,391.00 | 1 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $5,063.00 – $6,859.00 | 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.