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 |
|---|---|---|---|---|
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $6,389.00 – $16,286.66 | 3 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | not published | not published | $6,389.00 – $15,026.00 | 2 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $6,389.00 – $9,765.44 | 3 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $6,760.00 – $16,286.66 | 3 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $6,389.00 – $9,765.44 | 3 |
| Rpr acq av fistula thrx&abd CPT 35189 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | $8,245.00 – $15,511.46 | 3 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $6,369.09 | $16,331.00 | $8,245.00 – $15,511.46 | 3 |
| Rpr blvs gr ot/th vn ntrth w CPT 35271 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr blvs gr ot/t vn ntrth wo CPT 35276 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr blvsl gr ot/th vn ntr-ab CPT 35281 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr blvsl vn grf intra-abdl CPT 35251 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr blvsl vn grf ntrthrc w/b CPT 35241 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr cgen av fistula thrx&abd CPT 35182 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $2,664.00 – $16,529.94 | 5 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $2,664.00 – $16,529.94 | 5 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $6,389.00 – $9,765.44 | 5 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $6,389.00 – $16,286.66 | 3 |
| Rpr hypopl a-arch w/byp CPT 33853 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr hypopl a-arch wo byp CPT 33852 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $1,937.00 – $14,605.40 | 5 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $1,937.00 – $9,840.21 | 5 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $2,323.00 – $9,765.44 | 5 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $2,323.00 – $9,765.44 | 5 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $6,389.00 – $9,765.44 | 5 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $2,323.00 – $21,354.98 | 5 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $6,760.00 – $9,765.44 | 3 |
| Rpr intst excl anrect fist HCPCS C9796 | not published | not published | $4,714.00 – $7,925.42 | 3 |
| Rpr nsl vlv collapse w/implt CPT 30468 | not published | not published | $9,000.00 – $16,529.94 | 3 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | $9,000.00 – $16,529.94 | 3 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | not published | not published | $6,389.00 – $15,026.00 | 2 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Rpr pul art unifocal without cpb CPT 33925 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $172.66 – $172.66 | 1 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $2,664.00 – $9,765.44 | 5 |
| Rpr tga aortic pulm art rcns CPT 33778 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga atr bfl clsr vsd CPT 33776 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga atr bfl rmvl plm bnd CPT 33775 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga atrial baffle px CPT 33774 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga bfl rpr sbpulm obstr CPT 33777 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga rcnstj clsr vsd CPT 33780 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga rcnstj rmvl plm bnd CPT 33779 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga rcnstj rpr sbpl obst CPT 33781 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga without surg enlgmnt vsd CPT 33770 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr tga w/surg enlgmnt vsd CPT 33771 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Rpr umbil hern block < 5 yr CPT 49582 | not published | not published | $5,063.00 – $9,032.00 | 3 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $1,694.00 – $20,193.44 | 5 |
| Rp therapy unlisted px CPT 79999 | $515.58 | $1,322.00 | $469.77 – $702.23 | 2 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $1,937.00 – $26,003.15 | 5 |
| Rsect hip tum incl femur CPT 27078 | not published | not published | $6,760.00 – $15,026.00 | 2 |
| Rsv assay w/optic CPT 87807 | $89.70 | $230.00 | $21.02 – $45.33 | 4 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $619.07 – $619.07 | 1 |
| Rubella antibody igg CPT 86762 | $72.15 | $185.00 | $25.22 – $49.79 | 4 |
| Rubeola ag if CPT 87283 | not published | not published | $21.02 – $210.37 | 4 |
| Rubeola antibody igg CPT 86765 | $129.48 | $332.00 | $22.57 – $44.56 | 4 |
| Runx1 gene targeted seq alys CPT 81334 | $543.27 | $1,393.00 | $395.41 – $1,140.10 | 4 |
| Russell viper venom diluted CPT 85613 | $125.19 | $321.00 | $16.76 – $33.15 | 4 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $3,173.10 – $3,173.10 | 1 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | not published | not published | $67.55 – $117.92 | 3 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $276.90 | $710.00 | $53.93 – $310.32 | 4 |
| Salivary gland function exam CPT 78232 | $719.16 | $1,844.00 | $192.85 – $1,164.18 | 4 |
| Salivary gland imaging CPT 78230 | $585.00 | $1,500.00 | $364.43 – $1,164.18 | 4 |
| Salivary glnd img serial img CPT 78231 | $585.00 | $1,500.00 | $246.78 – $1,164.18 | 4 |
| Salmonella antibody CPT 86768 | $85.02 | $218.00 | $23.10 – $45.64 | 4 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $6,179.00 – $8,824.63 | 3 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $2.36 – $2.36 | 1 |
| Sargramostim injection HCPCS J2820 | not published | not published | $114.40 – $205.25 | 3 |
| Sars-cov-2 antb quantitative CPT 86413 | $186.42 | $478.00 | $50.56 – $177.95 | 2 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $302.48 – $512.77 | 2 |
| Sarscov coronavirus ag ia CPT 87426 | $171.99 | $441.00 | $54.44 – $122.24 | 2 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $171.99 | $441.00 | $88.28 – $243.20 | 2 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $6,760.00 – $16,086.99 | 5 |
| Sbsq psyc collab care mgmt CPT 99493 | not published | not published | $450.03 – $450.03 | 1 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $643.50 | $1,650.00 | $348.89 – $940.07 | 3 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $222.30 | $570.00 | $218.97 – $654.77 | 3 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $809.25 | $2,075.00 | $239.40 – $715.59 | 3 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $633.36 | $1,624.00 | $226.33 – $436.47 | 3 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $474.63 | $1,217.00 | $294.97 – $564.34 | 3 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $469.17 | $1,203.00 | $240.21 – $684.38 | 3 |
| Scan proc cranial extra CPT 61782 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Scan proc spinal CPT 61783 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $3,937.83 | $10,097.00 | $4,066.00 – $7,349.00 | 4 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $5,809.00 – $9,136.47 | 5 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,579.32 | $6,613.65 | not published | 0 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $19.94 – $61.45 | 3 |
| Scr c/v cyto,autosys and md HCPCS G0141 | not published | not published | $35.05 – $35.05 | 1 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $26.63 – $110.51 | 3 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $37.43 – $152.14 | 3 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $46.42 – $91.66 | 3 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $35.50 – $93.59 | 3 |
| Screen cerv/vag thin layer HCPCS G0123 | not published | not published | $35.50 – $70.10 | 3 |
| Screen c/v thin layer by md HCPCS G0124 | not published | not published | $35.05 – $35.05 | 1 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $1,694.00 – $4,714.00 | 5 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $1,694.00 – $4,714.00 | 5 |
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.