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 |
|---|---|---|---|---|
| Protein c concentrate HCPCS J2724 | not published | not published | $28.65 – $52.14 | 3 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $127.92 | $328.00 | $18.82 – $37.16 | 4 |
| Protein s total CPT 85305 | $346.71 | $889.00 | $20.32 – $40.17 | 4 |
| Protein total 24 hour urine CPT 84156 | $75.27 | $193.00 | $6.42 – $12.70 | 4 |
| Protein total body fluid CPT 84157 | $93.60 | $240.00 | $6.42 – $13.84 | 4 |
| Protein total serum plasma whole blood CPT 84155 | $69.81 | $179.00 | $6.42 – $12.70 | 4 |
| Protein western blot tissue CPT 88371 | not published | not published | $38.93 – $69.45 | 3 |
| Prothrombin complex kcentra HCPCS J7168 | not published | not published | $5.54 – $6.71 | 3 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $64.35 | $165.00 | $6.90 – $13.63 | 4 |
| Proton treatment complex CPT 77525 | not published | not published | $2,155.29 – $4,004.19 | 2 |
| Proton trmt intermediate CPT 77523 | not published | not published | $2,155.29 – $4,004.19 | 2 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $2,155.29 – $4,004.19 | 2 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $1,072.38 – $1,661.58 | 2 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $15.08 – $33.70 | 4 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $6,389.00 – $9,765.44 | 5 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $123.24 | $316.00 | not published | 0 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | $25,755.99 | $66,041.00 | $9,000.00 – $49,495.55 | 3 |
| Prq av fstl crt uxtr sep acs CPT 36837 | $25,755.99 | $66,041.00 | $9,000.00 – $49,495.55 | 3 |
| Prq card angio/athrect addl CPT 92925 | $2,230.80 | $5,720.00 | $3,391.00 – $16,710.00 | 2 |
| Prq cardiac angio addl art CPT 92921 | $2,435.55 | $6,245.00 | $3,391.00 – $15,026.00 | 2 |
| Prq card revasc chronic addl CPT 92944 | $12,141.09 | $31,131.00 | $3,391.00 – $15,026.00 | 2 |
| Prq card revasc mi 1 vsl CPT 92941 | $14,749.41 | $37,819.00 | $15,026.00 – $15,026.00 | 1 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $14,749.41 | $37,819.00 | $5,063.00 – $6,859.00 | 2 |
| Prq card stent/ath/angio CPT 92934 | $7,496.97 | $19,223.00 | $3,391.00 – $15,026.00 | 2 |
| Prq card stent w/angio addl CPT 92929 | $2,611.44 | $6,696.00 | $3,391.00 – $15,026.00 | 2 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $10,496.07 | $26,913.00 | $9,842.00 – $31,052.45 | 3 |
| Prq revasc byp graft addl CPT 92938 | $7,888.14 | $20,226.00 | $3,391.00 – $15,026.00 | 2 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | $28,472.73 | $73,007.00 | $1,694.00 – $20,193.44 | 5 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $1,694.00 – $6,179.00 | 5 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $1,694.00 – $20,193.44 | 5 |
| Prq skel fix talus fx w/mnpj CPT 28436 | $12,733.89 | $32,651.00 | $1,694.00 – $20,193.44 | 5 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $1,694.00 – $20,193.44 | 5 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $9,761.70 | $25,030.00 | $9,842.00 – $31,052.45 | 3 |
| Prq trlml c athrc st angiop1 CPT 92933 | $11,115.78 | $28,502.00 | $9,842.00 – $49,495.55 | 3 |
| Prq trluml c angiop 1art&/br CPT 92920 | $4,644.51 | $11,909.00 | $9,000.00 – $16,133.35 | 3 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $7,809.36 | $20,024.00 | $9,000.00 – $31,052.45 | 3 |
| Prq trluml revsc ch occ ant CPT 92943 | $14,749.41 | $37,819.00 | $9,842.00 – $31,052.45 | 3 |
| Pr removal drug delivery implant CPT 11982 | $5,250.57 | $13,463.00 | $1,124.66 – $3,391.00 | 3 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $368.55 | $945.00 | $360.57 – $5,063.00 | 3 |
| Pr removal intrauterine device CPT 58301 | $836.16 | $2,144.00 | $905.52 – $3,391.00 | 4 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $821.73 | $2,107.00 | $1,125.52 – $3,391.00 | 4 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $741.00 | $1,900.00 | $565.10 – $5,063.00 | 3 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $741.00 | $1,900.00 | $565.10 – $5,063.00 | 3 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $741.00 | $1,900.00 | $565.10 – $3,391.00 | 3 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $741.00 | $1,900.00 | $565.10 – $5,063.00 | 3 |
| Pr robotic surgical system HCPCS S2900 | $874.38 | $2,242.00 | $5,063.00 – $5,063.00 | 1 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $1,225.32 – $3,391.00 | 4 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $2,323.00 – $20,193.44 | 5 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $3,189.81 | $8,179.00 | $2,572.00 – $4,714.00 | 4 |
| PSA (Prostate) Test CPT 84153 | $206.31 | $529.00 | $32.22 – $63.63 | 4 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | not published | not published | $84.05 – $84.05 | 1 |
| Psychoanalysis CPT 90845 | not published | not published | $450.03 – $450.03 | 1 |
| Psychoeducation 45 min + HCPCS G0177 | $288.99 | $741.00 | not published | 0 |
| Psychotherapy group therapy CPT 90853 | $366.99 | $941.00 | not published | 0 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $308.10 | $790.00 | $450.03 – $450.03 | 1 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $389.22 | $998.00 | $450.03 – $450.03 | 1 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $759.33 | $1,947.00 | $450.03 – $450.03 | 1 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $228.93 | $587.00 | $885.97 – $885.97 | 1 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | $134.94 | $346.00 | not published | 0 |
| Psycl/nrpsyc tech 1st CPT 96138 | $371.67 | $953.00 | not published | 0 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $286.26 | $734.00 | $360.57 – $360.57 | 1 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | $239.46 | $614.00 | not published | 0 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | $123.63 | $317.00 | not published | 0 |
| Psytx complex interactive CPT 90785 | $374.01 | $959.00 | not published | 0 |
| Psytx pt w/e&m 16-37 min CPT 90833 | $55.38 | $142.00 | not published | 0 |
| Psytx pt w/e&m 38-52 min CPT 90836 | $55.38 | $142.00 | not published | 0 |
| Psytx pt w/e&m 53+ min CPT 90838 | $55.38 | $142.00 | not published | 0 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $23.40 | $60.00 | not published | 0 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $78.39 | $201.00 | not published | 0 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $58.11 | $149.00 | not published | 0 |
| Pt application of modality traction mechanical CPT 97012 | $78.39 | $201.00 | not published | 0 |
| Pten gene dup/delet variant CPT 81323 | $239.46 | $614.00 | $105.12 – $1,038.00 | 4 |
| Pten gene full sequence CPT 81321 | $2,259.27 | $5,793.00 | $720.84 – $2,076.00 | 4 |
| Pten gene known fam variant CPT 81322 | not published | not published | $70.08 – $161.24 | 4 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $5,063.00 – $16,529.94 | 3 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $241.02 | $618.00 | not published | 0 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $213.33 | $547.00 | not published | 0 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $83.07 | $213.00 | not published | 0 |
| Pt wheelchair management each 15 minutes CPT 97542 | $117.78 | $302.00 | not published | 0 |
| Pul art balloon repr percut CPT 92997 | $5,026.71 | $12,889.00 | $9,000.00 – $31,052.45 | 3 |
| Pul art balloon repr percut CPT 92998 | $3,518.58 | $9,022.00 | $15,026.00 – $15,026.00 | 1 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $6,600.00 – $19,030.00 | 2 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pulmonary vent imaging CPT 78579 | $1,333.80 | $3,420.00 | $388.93 – $1,164.18 | 4 |
| Pulse ox continuous overnight monitoring CPT 94762 | $394.29 | $1,011.00 | $440.91 – $440.91 | 1 |
| Pulse ox multiple CPT 94761 | $261.30 | $670.00 | not published | 0 |
| Pulse ox single CPT 94760 | $30.81 | $79.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | $2,507.31 | $6,429.00 | $1,308.00 – $4,066.00 | 5 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $78.78 | $202.00 | $360.57 – $2,665.00 | 2 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $794.82 | $2,038.00 | $1,125.52 – $3,391.00 | 3 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $1,308.00 – $9,087.85 | 5 |
| Puncture spinal lumbar diagnostic CPT 62270 | $2,049.06 | $5,254.00 | $1,308.00 – $4,066.00 | 5 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $195.92 – $195.92 | 1 |
| Puraply xt 1 sq cm HCPCS Q4197 | $8,011.65 | $20,542.68 | $138.45 – $138.45 | 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.