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 |
|---|---|---|---|---|
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Optx thigh fx CPT 27269 | not published | not published | $4,714.00 – $5,272.00 | 2 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $1,937.00 – $11,889.00 | 5 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $4,220.00 – $20,193.44 | 4 |
| Oral aprepitant HCPCS J8501 | not published | not published | $5.45 – $5.45 | 1 |
| Oral busulfan HCPCS J8510 | not published | not published | $267.05 – $267.05 | 1 |
| Oral everolimus HCPCS J7527 | not published | not published | $4.42 – $4.42 | 1 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | not published | not published | $20.26 – $41.45 | 3 |
| Oral methotrexate (jylamvo) HCPCS J8611 | not published | not published | $35.49 – $57.93 | 2 |
| Oral methotrexate (xatmep) HCPCS J8612 | not published | not published | $40.50 – $61.98 | 2 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $762.15 – $1,418.81 | 3 |
| Orbitocranial approach/skull CPT 61584 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Orbitocranial approach/skull CPT 61585 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Orchiectomy partial CPT 54522 | not published | not published | $1,937.00 – $9,840.21 | 5 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $2,323.00 – $9,765.44 | 4 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $2,323.00 – $9,765.44 | 5 |
| Organic acids total quant ea spec CPT 83918 | $185.72 | $476.20 | $28.85 – $81.66 | 4 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $82.57 – $141.58 | 3 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | not published | not published | $54.38 – $95.50 | 3 |
| Oropharyngeal biopsy 42800 CPT 42800 | $1,311.18 | $3,362.00 | $1,308.00 – $4,304.67 | 4 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | not published | not published | $26.66 – $26.66 | 1 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $279.81 | $717.46 | not published | 0 |
| Ortho elbow w/lock w/ft&adj HCPCS L3760 | $693.87 | $1,779.16 | not published | 0 |
| Ortho ewhf rigd without jnt cstm w HCPCS L3765 | $830.31 | $2,129.00 | not published | 0 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $772.99 | $1,982.02 | not published | 0 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $284.55 | $729.62 | not published | 0 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $315.01 | $807.71 | not published | 0 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $267.74 | $686.52 | not published | 0 |
| Orthopantogram CPT 70355 | $248.04 | $636.00 | $22.07 – $256.49 | 4 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $172.66 – $172.66 | 1 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $662.39 | $1,698.44 | not published | 0 |
| Orthovisc inj per dose HCPCS J7324 | not published | not published | $175.62 – $452.01 | 3 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $611.08 | $1,566.88 | not published | 0 |
| Ortho wrst/hnd w/jnt cstm w/fit&adj HCPCS L3905 | $410.92 | $1,053.63 | not published | 0 |
| Oscillation chest wall mechanical per session CPT 94669 | $566.28 | $1,452.00 | $602.04 – $602.04 | 1 |
| Osmolality blood CPT 83930 | $114.27 | $293.00 | $11.58 – $22.87 | 4 |
| Osmolality urine CPT 83935 | $125.97 | $323.00 | $11.94 – $23.60 | 4 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Osteoart algrft w/surf & b1 CPT 20932 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $5,809.00 – $37,149.33 | 3 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $6,389.00 – $20,193.44 | 4 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $6,389.00 – $20,193.44 | 4 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | $46.80 | $120.00 | not published | 0 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | $101.40 | $260.00 | not published | 0 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | $95.16 | $244.00 | not published | 0 |
| Osteoplasty humerus CPT 24420 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Other bone graft microvasc CPT 20962 | not published | not published | $2,323.00 – $11,889.00 | 3 |
| Other immunoelectrophoresis CPT 86325 | $44.07 | $113.00 | $39.18 – $80.03 | 4 |
| Oth resp proc, group HCPCS G0239 | $194.22 | $498.00 | not published | 0 |
| Oth resp proc, indiv HCPCS G0238 | $139.23 | $357.00 | $84.05 – $84.05 | 1 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $68.25 | $175.00 | not published | 0 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $46.41 | $119.00 | not published | 0 |
| Otoplasty 69300 CPT 69300 | not published | not published | $1,937.00 – $9,087.85 | 5 |
| Ot re-evaluation patient/family CPT 97168 | $96.33 | $247.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $57.72 | $148.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $72.54 | $186.00 | not published | 0 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $2,664.00 – $14,039.62 | 4 |
| Ovine, 1000 usp units HCPCS J3472 | not published | not published | $262.65 – $262.65 | 1 |
| Ovulation tests CPT 84830 | not published | not published | $17.58 – $43.94 | 4 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $2.04 – $2.04 | 1 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | not published | not published | $0.15 – $0.15 | 1 |
| Oxymorphone hcl injection HCPCS J2410 | not published | not published | $5.43 – $5.43 | 1 |
| Oxytetracycline injection HCPCS J2460 | not published | not published | $1.79 – $1.79 | 1 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | not published | not published | $2.73 – $2.73 | 1 |
| P-32 chromic phos ther per mci HCPCS A9564 | not published | not published | $245.28 – $245.28 | 1 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $592.71 – $1,214.60 | 2 |
| Pabpn1 gene detc abnor allel CPT 81312 | $225.42 | $578.00 | $164.40 – $474.02 | 3 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | not published | not published | $0.21 – $0.21 | 1 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | not published | not published | $25.81 – $49.44 | 3 |
| Palb2 gene full gene seq CPT 81307 | $466.44 | $1,196.00 | $339.46 – $2,340.69 | 2 |
| Palb2 gene known famil vrnt CPT 81308 | $496.86 | $1,274.00 | $361.62 – $1,042.67 | 2 |
| Palifermin injection HCPCS J2425 | not published | not published | $63.41 – $91.72 | 3 |
| Palingen or palingen xplus HCPCS Q4173 | not published | not published | $1,312.28 – $1,312.28 | 1 |
| Palingen or promatrx HCPCS Q4174 | not published | not published | $2,420.43 – $2,420.43 | 1 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | not published | not published | $28.08 – $49.55 | 3 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $1,016.61 – $3,886.60 | 3 |
| Palonosetron hcl HCPCS J2469 | not published | not published | $1.09 – $1.09 | 1 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | not published | not published | $23.98 – $23.98 | 1 |
| Pancreas removal/transplant CPT 48160 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pancreatectomy CPT 48146 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pancreatectomy CPT 48152 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pancreatectomy CPT 48154 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pancreatectomy 48153 CPT 48153 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pancreatorrhaphy CPT 48545 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $315.84 – $521.28 | 3 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | not published | not published | $8.84 – $8.84 | 1 |
| Papaverin hcl injection HCPCS J2440 | not published | not published | $72.90 – $72.90 | 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.