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 |
|---|---|---|---|---|
| Pvb thoracic 2nd+ inj site CPT 64462 | $4,058.34 | $10,406.00 | $2,665.00 – $3,391.00 | 2 |
| Pvb thoracic cont infusion CPT 64463 | $2,706.21 | $6,939.00 | $1,952.00 – $4,066.00 | 3 |
| Pvb thoracic single inj site CPT 64461 | $2,446.08 | $6,272.00 | $1,952.00 – $4,066.00 | 3 |
| Pyelotomy complicated CPT 50135 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $2,323.00 – $6,859.00 | 3 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Pyridoxine hcl 100 mg HCPCS J3415 | not published | not published | $30.08 – $30.08 | 1 |
| Pyruvate CPT 84210 | $124.80 | $320.00 | $19.02 – $50.10 | 4 |
| Pyruvate kinase CPT 84220 | $202.02 | $518.00 | $16.52 – $32.66 | 4 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $360.57 – $360.57 | 1 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $640.38 | $1,642.00 | $634.88 – $1,525.66 | 4 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,503.06 | $3,854.00 | $399.55 – $1,164.18 | 4 |
| Quest t3 uptake CPT 84479 | $106.86 | $274.00 | $11.34 – $22.39 | 4 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $18.65 – $1,135.07 | 3 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $881.97 – $1,435.73 | 3 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $592.57 – $886.83 | 3 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $715.61 – $1,003.33 | 3 |
| Rabies vaccine id CPT 90676 | not published | not published | $502.52 – $835.46 | 2 |
| Radial keratotomy CPT 65771 | not published | not published | $6,179.00 – $9,000.00 | 2 |
| Radiation handling CPT 77790 | $331.89 | $851.00 | $153.41 – $197.90 | 2 |
| Radiation physics consult CPT 77336 | $489.84 | $1,256.00 | $254.94 – $382.99 | 2 |
| Radiation therapy dose plan CPT 77300 | $397.02 | $1,018.00 | $79.27 – $382.99 | 4 |
| Radiation treatment aid(s) CPT 77332 | $400.92 | $1,028.00 | $101.32 – $382.99 | 4 |
| Radiation treatment aid(s) CPT 77333 | $413.40 | $1,060.00 | $33.78 – $382.99 | 4 |
| Radiation treatment aid(s) CPT 77334 | $776.49 | $1,991.00 | $165.05 – $1,042.95 | 4 |
| Radiation treatment delivery CPT 77401 | $257.01 | $659.00 | $57.20 – $338.47 | 4 |
| Radiation treatment delivery CPT 77402 | $278.85 | $715.00 | $247.91 – $710.89 | 4 |
| Radiation treatment delivery CPT 77412 | $652.08 | $1,672.00 | $443.38 – $1,100.67 | 4 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $6,859.00 – $9,000.00 | 2 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Radical resection of elbow CPT 24149 | not published | not published | $6,389.00 – $20,193.44 | 3 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $4,714.00 – $8,020.55 | 4 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $5,809.00 – $9,032.00 | 4 |
| Radiesse injection HCPCS Q2026 | not published | not published | $682.03 – $894.06 | 2 |
| Radiology port images(s) CPT 77417 | $374.79 | $961.00 | $50.68 – $65.38 | 2 |
| Radiotherapy dose plan imrt CPT 77301 | $5,087.94 | $13,046.00 | $3,571.52 – $7,304.10 | 4 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $5,437.77 | $13,943.00 | $328.59 – $557.61 | 3 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $975.00 | $2,500.00 | $676.54 – $4,008.07 | 4 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,170.00 | $3,000.00 | $1,232.16 – $4,008.07 | 4 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $1,287.00 | $3,300.00 | not published | 0 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,209.00 | $3,100.00 | $695.33 – $4,008.07 | 4 |
| Radphm lcl tumor plr sgl day CPT 78800 | $780.00 | $2,000.00 | $381.58 – $1,164.18 | 4 |
| Radphm quant measure sgl area add-on CPT 78835 | $293.67 | $753.00 | not published | 0 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $1,937.00 – $8,020.55 | 5 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $5,809.00 – $9,032.00 | 4 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $1,937.00 – $8,020.55 | 5 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $1,937.00 – $8,020.55 | 5 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $5,809.00 – $9,032.00 | 4 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $1,937.00 – $8,020.55 | 5 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $5,809.00 – $9,032.00 | 4 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $4,714.00 – $8,020.55 | 3 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $138.97 – $243.03 | 3 |
| Range of motion measurements CPT 95852 | $165.36 | $424.00 | not published | 0 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $236.31 – $746.98 | 3 |
| Rapid desensitization CPT 95180 | $605.67 | $1,553.00 | not published | 0 |
| Rapid Strep Test CPT 87880 | $122.07 | $313.00 | $21.02 – $57.19 | 4 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $705.16 – $1,270.75 | 3 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $420.44 – $767.32 | 3 |
| Rb82 rubidium HCPCS A9555 | $453.18 | $1,162.00 | $732.70 – $732.70 | 1 |
| Rbc count only automated CPT 85041 | $39.39 | $101.00 | $5.28 – $10.45 | 4 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,073.28 | $2,752.00 | not published | 0 |
| Rbc depletion of harvest CPT 38212 | $866.97 | $2,223.00 | $1,225.32 – $5,063.00 | 4 |
| Rbc irradiated each unit HCPCS P9038 | $846.30 | $2,170.00 | not published | 0 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $15.07 – $29.76 | 4 |
| Rbc osmotic fragility CPT 85555 | $372.06 | $954.00 | $11.71 – $25.85 | 4 |
| Rbc serum pretx incubj drugs CPT 86975 | $223.08 | $572.00 | $28.51 – $1,124.66 | 4 |
| Rcm img acquisj only 1st les CPT 96932 | $75.66 | $194.00 | not published | 0 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $6,760.00 – $16,529.94 | 3 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $6,760.00 – $11,889.00 | 2 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $6,760.00 – $11,889.00 | 2 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | not published | not published | $6,389.00 – $11,889.00 | 2 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $5,809.00 – $9,087.85 | 3 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $5,809.00 – $16,529.94 | 3 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $5,063.00 – $16,529.94 | 3 |
| Realignment of knee CPT 27457 | not published | not published | $2,664.00 – $11,889.00 | 3 |
| Realignment of knee CPT 27455 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Realignment of tendons CPT 26437 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Realignment of thigh bone CPT 27454 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $2,664.00 – $16,529.94 | 5 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $2,664.00 – $16,529.94 | 5 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $3,721.00 – $16,529.94 | 5 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $1,937.00 – $16,529.94 | 5 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $3,721.00 – $16,529.94 | 5 |
| Rechanneling of artery CPT 35361 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rechanneling of artery CPT 35306 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rechanneling of artery CPT 35311 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rechanneling of artery CPT 35363 | 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.