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 |
|---|---|---|---|---|
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $38.08 – $444.35 | 3 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $215.83 – $644.08 | 3 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $258.36 – $486.04 | 3 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $568.58 – $1,137.09 | 2 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $238.82 – $476.60 | 3 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $349.79 – $698.82 | 2 |
| Peginesatide injection HCPCS J0890 | not published | not published | $15.63 – $15.63 | 1 |
| Peg interferon alfa-2a/180 HCPCS S0145 | not published | not published | $2,164.63 – $2,164.63 | 1 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $6,766.40 – $11,663.94 | 3 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $432.26 – $736.84 | 2 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,872.00 | $4,800.00 | $457.55 – $529.55 | 3 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,602.51 | $4,109.00 | $385.65 – $518.62 | 3 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,310.40 | $3,360.00 | $209.99 – $310.32 | 3 |
| Pelvic exenteration CPT 45126 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,090.79 | $5,361.00 | $902.02 – $1,124.96 | 3 |
| Pelvic MRI (with contrast) CPT 72196 | $1,854.06 | $4,754.00 | $744.34 – $1,085.52 | 3 |
| Pelvic MRI (without contrast) CPT 72195 | $1,810.38 | $4,642.00 | $691.66 – $850.73 | 3 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $6,760.00 – $20,193.44 | 4 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $8,245.00 – $15,026.00 | 2 |
| Pelvic Ultrasound (complete) CPT 76856 | $614.64 | $1,576.00 | $142.94 – $310.32 | 4 |
| Pelvic Ultrasound (limited) CPT 76857 | $370.11 | $949.00 | $53.93 – $310.32 | 4 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $242.58 | $622.00 | $53.12 – $310.32 | 4 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $264.42 | $678.00 | $62.10 – $310.32 | 4 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $109.79 – $192.83 | 3 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $10.04 – $202.41 | 3 |
| Pemivibart infusion HCPCS M0224 | $527.28 | $1,352.00 | not published | 0 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $31.22 – $60.83 | 3 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $40.07 – $75.19 | 3 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | not published | not published | $1.43 – $1.43 | 1 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $89.33 – $122.53 | 2 |
| Penile injection CPT 54235 | $736.71 | $1,889.00 | $697.61 – $5,063.00 | 3 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $21,728.88 | $55,715.08 | not published | 0 |
| Penile vascular study CPT 93980 | $326.82 | $838.00 | $138.09 – $477.02 | 3 |
| Penile vascular study CPT 93981 | $192.66 | $494.00 | $119.30 – $419.31 | 3 |
| Penile venous occlusion CPT 37790 | not published | not published | $1,937.00 – $9,840.21 | 5 |
| Penis plastic surgery CPT 54360 | not published | not published | $1,937.00 – $11,889.00 | 5 |
| Penis study CPT 54240 | not published | not published | $885.97 – $3,391.00 | 3 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $151.32 – $151.32 | 1 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $24.24 – $24.24 | 1 |
| Pentazocine injection HCPCS J3070 | not published | not published | $206.59 – $206.59 | 1 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $102.70 – $102.70 | 1 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $5,208.20 – $7,865.10 | 3 |
| Perc cryo ablate renal tum CPT 50593 | $12,071.67 | $30,953.00 | $9,032.00 – $29,055.57 | 4 |
| Perc d-e cor revasc chro add HCPCS C9608 | $12,141.09 | $31,131.00 | $2,665.00 – $5,063.00 | 2 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $14,749.41 | $37,819.00 | $9,842.00 – $49,495.55 | 3 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $10,496.07 | $26,913.00 | $2,665.00 – $5,063.00 | 2 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $10,496.07 | $26,913.00 | $9,842.00 – $31,052.45 | 3 |
| Perc d-e cor stent ather br HCPCS C9603 | $7,496.97 | $19,223.00 | $2,665.00 – $5,063.00 | 2 |
| Perc d-e cor stent ather s HCPCS C9602 | $10,105.29 | $25,911.00 | $9,842.00 – $49,495.55 | 3 |
| Perc drug-el cor stent bran HCPCS C9601 | $2,611.44 | $6,696.00 | $2,665.00 – $3,391.00 | 2 |
| Perc drug-el cor stent sing HCPCS C9600 | $8,913.84 | $22,856.00 | $9,842.00 – $31,052.45 | 3 |
| Perc rf ablate renal tumor CPT 50592 | $6,016.14 | $15,426.00 | $2,572.00 – $16,286.66 | 4 |
| Percut ablate liver rf CPT 47382 | $3,271.32 | $8,388.00 | $6,389.00 – $16,286.66 | 3 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $377.60 | $968.20 | $79.31 – $79.31 | 1 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $2,688.27 | $6,893.00 | $5,063.00 – $6,859.00 | 2 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,688.27 | $6,893.00 | $4,066.00 – $7,349.00 | 4 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $2,323.00 – $10,759.21 | 5 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $2,664.00 – $8,824.63 | 5 |
| Peripheral vascular rehab CPT 93668 | $183.30 | $470.00 | $172.66 – $172.66 | 1 |
| Peritoneal cath sub q resv per CPT 49419 | $6,493.50 | $16,650.00 | $1,308.00 – $15,511.46 | 5 |
| Peritoneogram rs&i CPT 74190 | $223.47 | $573.00 | $82.58 – $1,557.18 | 4 |
| Perit-vens shunt pat tst CPT 78291 | $580.71 | $1,489.00 | $511.49 – $1,164.18 | 4 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.91 – $0.91 | 1 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $12.16 – $12.16 | 1 |
| Perq art m-thrombect &/nfs CPT 61645 | $31,265.52 | $80,168.00 | $6,859.00 – $8,245.00 | 2 |
| Perq clsr tcat l atr apndge CPT 33340 | $12,032.67 | $30,853.00 | $6,859.00 – $6,859.00 | 1 |
| Perq dev breast 1st mr guide CPT 19287 | $3,033.03 | $7,777.00 | $1,985.95 – $5,809.00 | 4 |
| Perq dev breast 1st strtctc CPT 19283 | $1,821.30 | $4,670.00 | $1,985.95 – $4,714.00 | 4 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $6,760.00 – $26,003.15 | 3 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $8,748.48 | $22,432.00 | $2,323.00 – $26,003.15 | 4 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $15,916.29 | $40,811.00 | $9,842.00 – $31,052.45 | 3 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $22,633.26 | $58,034.00 | $9,842.00 – $49,495.55 | 3 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | $15,916.29 | $40,811.00 | $9,000.00 – $31,052.45 | 3 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $22,633.26 | $58,034.00 | $9,000.00 – $31,052.45 | 3 |
| Perq p-art revsc each addl CPT 33904 | $7,958.34 | $20,406.00 | $2,665.00 – $3,391.00 | 2 |
| Perq plmt bile duct stent CPT 47538 | $4,248.27 | $10,893.00 | $5,809.00 – $16,286.66 | 4 |
| Perq plmt bile duct stent CPT 47539 | $4,837.95 | $12,405.00 | $5,809.00 – $16,286.66 | 4 |
| Perq plmt bile duct stent CPT 47540 | $5,203.38 | $13,342.00 | $5,809.00 – $16,286.66 | 4 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $636.09 | $1,631.00 | $697.61 – $3,391.00 | 4 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $1,308.00 – $9,136.47 | 5 |
| Perq skel fix ulnar styld fx CPT 25651 | $14,239.29 | $36,511.00 | $3,391.00 – $9,136.47 | 4 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $1,308.00 – $5,063.00 | 3 |
| Perq transcath closure each CPT 93592 | $7,544.16 | $19,344.00 | $2,665.00 – $3,391.00 | 2 |
| Perq transcath closure pda CPT 93582 | $13,110.63 | $33,617.00 | $9,842.00 – $49,495.55 | 3 |
| Perq transcath cls aortic CPT 93591 | $22,633.26 | $58,034.00 | $9,842.00 – $56,095.00 | 3 |
| Perq transcath cls mitral CPT 93590 | $22,633.26 | $58,034.00 | $9,842.00 – $56,095.00 | 3 |
| Perq transcath septal reduxn CPT 93583 | $6,003.27 | $15,393.00 | $6,859.00 – $9,842.00 | 2 |
| Perq trluml angp nt/recr coa CPT 33897 | $22,633.26 | $58,034.00 | $5,063.00 – $6,859.00 | 2 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $14,239.29 | $36,511.00 | $1,694.00 – $9,136.47 | 5 |
| Perq tx malar fracture CPT 21355 | not published | not published | $1,937.00 – $11,889.00 | 5 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $1,694.00 – $16,529.94 | 5 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $2,323.00 – $11,889.00 | 5 |
| Pertussis ag if CPT 87265 | $221.13 | $567.00 | $21.02 – $41.45 | 4 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $30.86 – $53.39 | 3 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $121.76 – $231.99 | 3 |
| Pet CT skull-mid thgh initial CPT 78815 | $3,529.11 | $9,049.00 | $2,038.38 – $4,415.92 | 3 |
| Pet CT whole body initial CPT 78816 | $3,529.11 | $9,049.00 | $2,062.90 – $4,415.92 | 3 |
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.