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 |
|---|---|---|---|---|
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $2,666.82 | $6,838.00 | not published | 0 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $3,262.74 | $8,366.00 | not published | 0 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $3,162.12 | $8,108.00 | not published | 0 |
| Platelet survival CPT 78191 | $545.61 | $1,399.00 | $329.31 – $1,164.18 | 4 |
| Plcg2 gene common variants CPT 81320 | $478.92 | $1,228.00 | $349.63 – $1,008.11 | 3 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $4,406.61 | $11,299.00 | $4,714.00 – $9,765.44 | 4 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $5,630.43 | $14,437.00 | $2,665.00 – $3,391.00 | 2 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $6,036.03 | $15,477.00 | $5,809.00 – $9,840.21 | 4 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $6,328.92 | $16,228.00 | $5,809.00 – $9,840.21 | 4 |
| Plcmt dlyd xtn pros 1st vsl CPT 34710 | not published | not published | $6,389.00 – $6,859.00 | 2 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $2,091.18 | $5,362.00 | $1,985.95 – $4,714.00 | 4 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $2,091.18 | $5,362.00 | $2,665.00 – $3,391.00 | 2 |
| Plcmt xtn pros evasc rpr per vsl CPT 34709 | $2,222.61 | $5,699.00 | $3,391.00 – $6,859.00 | 2 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $1,516.71 | $3,889.00 | $2,665.00 – $3,391.00 | 2 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $665.73 | $1,707.00 | $2,665.00 – $3,391.00 | 2 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $665.73 | $1,707.00 | $2,665.00 – $3,391.00 | 2 |
| Plerixafor injection HCPCS J2562 | not published | not published | $70.67 – $1,014.02 | 3 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $532.35 | $1,365.00 | $885.97 – $885.97 | 1 |
| Pleurectomy parietal ; separate 32310 CPT 32310 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Plmt access bil tree sm bwl CPT 47541 | $3,931.20 | $10,080.00 | $4,714.00 – $21,354.98 | 4 |
| Plmt biliary drainage cath CPT 47534 | $4,720.17 | $12,103.00 | $4,714.00 – $9,765.44 | 4 |
| Plmt nephroureteral catheter CPT 50433 | $6,119.49 | $15,691.00 | $4,714.00 – $9,840.21 | 4 |
| Plmt ureteral stent prq CPT 50694 | $6,036.03 | $15,477.00 | $5,809.00 – $9,840.21 | 4 |
| Pm device progr eval dual CPT 93280 | $109.20 | $280.00 | not published | 0 |
| Pm device progr eval multi CPT 93281 | $67.47 | $173.00 | not published | 0 |
| Pml/raralpha 1 breakpoint CPT 81316 | not published | not published | $517.67 – $987.79 | 4 |
| Pmp22 gene dup/delet CPT 81324 | not published | not published | $599.21 – $2,623.93 | 3 |
| Pmp22 gene full sequence CPT 81325 | not published | not published | $742.09 – $2,662.75 | 3 |
| Pmp22 gene known fam variant CPT 81326 | not published | not published | $63.42 – $560.14 | 3 |
| Pms2 gene dup/delet variants CPT 81319 | not published | not published | $265.99 – $704.11 | 4 |
| Pms2 gene full seq analysis CPT 81317 | not published | not published | $937.55 – $2,340.69 | 4 |
| Pms2 known familial variants CPT 81318 | not published | not published | $221.53 – $1,145.26 | 4 |
| Pneumothrx tx-intraplrl inj ai CPT 32960 | not published | not published | $1,773.21 – $5,063.00 | 4 |
| #pnh-flow cytometry interp CPT 88187 | not published | not published | $12.07 – $88.98 | 3 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $264.81 | $679.00 | $33.90 – $90.20 | 4 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | not published | not published | $253.35 – $430.04 | 3 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $3,557.58 | $9,122.00 | not published | 0 |
| Polysom any age 1-3> param CPT 95808 | $1,203.93 | $3,087.00 | not published | 0 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $3,343.86 | $8,574.00 | not published | 0 |
| Polyvalent mult org ea ag ia CPT 87451 | not published | not published | $16.79 – $36.36 | 4 |
| Porfimer sodium injection HCPCS J9600 | not published | not published | $45,342.71 – $71,439.90 | 3 |
| Positional change of finger CPT 26555 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Post 1 srfc resinbased cmpst HCPCS D2391 | not published | not published | $1,694.00 – $2,485.25 | 2 |
| Post 2 srfc resinbased cmpst HCPCS D2392 | not published | not published | $1,694.00 – $2,485.25 | 2 |
| Post >=4srfc resinbase cmpst HCPCS D2394 | not published | not published | $1,694.00 – $2,485.25 | 2 |
| Post-coital mucous exam HCPCS Q0115 | not published | not published | $17.34 – $86.50 | 3 |
| Post non-seg/spine instrumentation 22840 CPT 22840 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Postop app non-wgt bear dsg HCPCS L5450 | $571.61 | $1,465.66 | not published | 0 |
| Postpartum Care Only CPT 59430 | not published | not published | $3,391.00 – $3,391.00 | 1 |
| Post seg spine instrument/3-6 seg 22842 CPT 22842 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Potassium 24 hour urine CPT 84133 | $75.66 | $194.00 | $7.54 – $16.37 | 4 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | not published | not published | $0.19 – $0.19 | 1 |
| Potassium hydroxide preps HCPCS Q0112 | not published | not published | $7.48 – $20.17 | 3 |
| Potassium serum/plasma/whole blood CPT 84132 | $75.27 | $193.00 | $8.04 – $16.47 | 4 |
| Ppp2r2b gen detc abnor allel CPT 81343 | $225.42 | $578.00 | $164.40 – $474.02 | 3 |
| Pq biliary strict dil s&i CPT 74363 | $1,102.53 | $2,827.00 | $281.89 – $363.64 | 2 |
| Pq dr cath chg w cont s&i CPT 75984 | $711.36 | $1,824.00 | $281.54 – $363.19 | 2 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $9,898.59 | $25,381.00 | $6,760.00 – $20,193.44 | 3 |
| Pq thr inj ext pse CPT 36002 | $532.74 | $1,366.00 | $1,773.21 – $4,066.00 | 4 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $3,226.47 | $8,273.00 | $2,665.00 – $9,032.00 | 3 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $12,164.49 | $31,191.00 | $6,389.00 – $9,136.47 | 4 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $10,935.21 | $28,039.00 | $6,389.00 – $9,136.47 | 4 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $712.41 – $1,000.42 | 3 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | not published | not published | $168.55 – $168.55 | 1 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $3,281.46 | $8,414.00 | $1,694.00 – $9,136.47 | 5 |
| Pr application of long arm splint CPT 29105 | $549.12 | $1,408.00 | $444.76 – $5,063.00 | 3 |
| Pr application splint static short arm CPT 29125 | $614.64 | $1,576.00 | $360.57 – $5,063.00 | 3 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | $43.29 | $111.00 | not published | 0 |
| Pr biopsy skin punch single lesion CPT 11104 | $560.04 | $1,436.00 | $1,125.52 – $3,391.00 | 3 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Pr correction hammertoe CPT 28285 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $51.87 | $133.00 | not published | 0 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | $2,688.27 | $6,893.00 | $5,063.00 – $6,859.00 | 2 |
| Prcrd drg 6+yr without anomly CPT 33017 | $6,075.03 | $15,577.00 | $5,063.00 – $6,859.00 | 2 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $6,766.11 | $17,349.00 | $1,694.00 – $9,840.21 | 5 |
| Prealbumin CPT 84134 | $143.13 | $367.00 | $25.56 – $50.48 | 4 |
| Prednisolone acetate inj HCPCS J2650 | not published | not published | $0.99 – $0.99 | 1 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | not published | not published | $1.09 – $1.09 | 1 |
| Prednisone 1 mg tablet HCPCS J7512 | not published | not published | $0.02 – $0.02 | 1 |
| Prefab stnlss steel crown pe HCPCS D2931 | not published | not published | $1,694.00 – $2,485.25 | 2 |
| Prefab stnlss steel crwn pri HCPCS D2930 | not published | not published | $1,694.00 – $2,485.25 | 2 |
| Pregabalin - sendout CPT 80366 | not published | not published | $25.87 – $25.87 | 1 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $4,036.89 | $10,351.00 | $1,694.00 – $5,371.00 | 5 |
| Pregnancy associated plasma protein-a CPT 84163 | not published | not published | $26.38 – $52.07 | 4 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $572.13 | $1,467.00 | $155.88 – $310.32 | 4 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $539.37 | $1,383.00 | $123.26 – $310.32 | 4 |
| Pregnancy Ultrasound (limited) CPT 76815 | $334.23 | $857.00 | $92.69 – $310.32 | 4 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $885.97 – $885.97 | 1 |
| Preparation for bladder xray CPT 51605 | not published | not published | $1,308.00 – $5,063.00 | 3 |
| Preparation palate mold CPT 42280 | not published | not published | $1,553.04 – $3,391.00 | 3 |
| Prepare donor heart CPT 33944 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Prepare donor intestine CPT 44715 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Prepare donor lung double CPT 32856 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Prepare donor lung single CPT 32855 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $65.18 – $236.25 | 3 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $3,391.00 – $3,391.00 | 1 |
| Prepare heart-aorta conduit CPT 33404 | 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.