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 |
|---|---|---|---|---|
| So neo gsap dna mcrstl ins CPT 81457 | $4,563.00 | $11,700.00 | not published | 0 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $42.71 – $68.31 | 3 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $3,391.00 – $8,448.00 | 2 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $3,391.00 – $8,448.00 | 2 |
| Sp bone algrft morsel add-on CPT 20930 | $803.40 | $2,060.00 | $2,665.00 – $3,391.00 | 2 |
| Special physics consult CPT 77370 | $477.75 | $1,225.00 | $254.94 – $382.99 | 2 |
| Special radiation dosimetry CPT 77331 | $353.34 | $906.00 | $44.14 – $382.99 | 4 |
| Special radiation treatment CPT 77470 | $1,515.93 | $3,887.00 | $89.89 – $1,661.58 | 4 |
| Special teletx port plan CPT 77321 | $696.93 | $1,787.00 | $101.32 – $1,042.95 | 4 |
| Specific gravity body fluid CPT 84315 | $33.15 | $85.00 | $4.39 – $11.35 | 4 |
| Specimen fat stain CPT 89125 | $102.96 | $264.00 | $7.56 – $20.34 | 4 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $244.14 | $626.00 | not published | 0 |
| Speech audiometry complete CPT 92556 | $172.77 | $443.00 | $172.66 – $172.66 | 1 |
| Speech evaluation complex CPT 70371 | $598.26 | $1,534.00 | $110.30 – $691.66 | 4 |
| Speech recep thresh CPT 92555 | $130.26 | $334.00 | $172.66 – $172.66 | 1 |
| Speech Therapy Session (one-on-one) CPT 92507 | $172.77 | $443.00 | not published | 0 |
| Sperm antibody test CPT 89325 | not published | not published | $18.70 – $36.92 | 4 |
| Sperm evaluation test CPT 89329 | not published | not published | $36.73 – $67.78 | 4 |
| Sperm identification CPT 89257 | $88.14 | $226.00 | $65.18 – $152.95 | 3 |
| Sperm isolation complex CPT 89261 | not published | not published | $65.18 – $152.95 | 3 |
| Sperm isolation simple CPT 89260 | not published | not published | $65.18 – $152.95 | 3 |
| Sperm washing 58323 CPT 58323 | not published | not published | $562.46 – $5,063.00 | 4 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $2,323.00 – $16,529.94 | 5 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $1,937.00 – $8,448.00 | 5 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $2,665.00 – $3,391.00 | 2 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $3,391.00 – $8,448.00 | 2 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $2,049.06 | $5,254.00 | $1,952.00 – $4,066.00 | 4 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $6,760.00 – $37,149.33 | 3 |
| Spine X-ray (single view, one level) CPT 72020 | $182.13 | $467.00 | $32.69 – $256.49 | 4 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $885.97 – $885.97 | 1 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $440.91 – $440.91 | 1 |
| Spleen imaging CPT 78185 | $773.76 | $1,984.00 | $458.38 – $1,164.18 | 4 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Splicing of ureters CPT 50770 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $418.94 | $1,074.20 | not published | 0 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $4,560.66 | $11,694.00 | $1,694.00 – $10,126.62 | 5 |
| Split blood or products CPT 86985 | $157.95 | $405.00 | $17.39 – $482.12 | 4 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | not published | not published | $1,937.00 – $5,809.00 | 3 |
| Sprchoroidal spc njx rx agt CPT 67516 | $453.57 | $1,163.00 | $955.94 – $5,063.00 | 3 |
| Sputum specimen collection CPT 89220 | not published | not published | $19.80 – $482.12 | 4 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $3,382.47 | $8,673.00 | $7,290.45 – $12,409.38 | 3 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $5,063.00 – $15,026.00 | 2 |
| Srs cranial lesion simple CPT 61796 | not published | not published | $5,063.00 – $15,026.00 | 2 |
| Srs cran les complex addl CPT 61799 | not published | not published | $5,063.00 – $5,272.00 | 2 |
| Srs cran les simple addl CPT 61797 | not published | not published | $5,063.00 – $5,272.00 | 2 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $210.48 – $606.88 | 2 |
| Srs linear based CPT 77372 | $18,301.53 | $46,927.00 | $2,488.03 – $21,980.75 | 4 |
| Srs multisource CPT 77371 | $61,542.78 | $157,802.00 | $2,827.00 – $21,980.75 | 4 |
| Srs spinal lesion CPT 63620 | not published | not published | $5,063.00 – $15,026.00 | 2 |
| Srs spinal lesion addl CPT 63621 | not published | not published | $5,063.00 – $5,272.00 | 2 |
| Staggered spondaic word test CPT 92572 | not published | not published | $440.91 – $440.91 | 1 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $244.14 | $626.00 | not published | 0 |
| Staph a dna amp probe CPT 87640 | $173.55 | $445.00 | $61.50 – $121.41 | 4 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $140.01 | $359.00 | not published | 0 |
| Stem cells total count CPT 86367 | $109.20 | $280.00 | $66.10 – $269.12 | 4 |
| Stenger test pure tone CPT 92565 | not published | not published | $172.66 – $172.66 | 1 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $17,598.75 | $45,125.00 | $6,389.00 – $56,095.00 | 3 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $46,500.48 | $119,232.00 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $1,322.36 | $3,390.66 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $26,466.66 | $67,863.22 | not published | 0 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $12,394.20 | $31,780.00 | $6,389.00 – $31,052.45 | 3 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $5,454.93 | $13,987.00 | $3,391.00 – $15,026.00 | 2 |
| Stent placemt retro carotid CPT 37217 | not published | not published | $5,809.00 – $6,859.00 | 2 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $10,995.27 | $28,193.00 | $6,389.00 – $49,495.55 | 3 |
| Stereoscopic x-ray guidance HCPCS G6002 | not published | not published | $128.28 – $248.14 | 2 |
| Stereotactic bx aspir/exc burr intracranial les 61750 CPT 61750 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Sterile water/saline, 10 ml HCPCS A4216 | $13.32 | $34.16 | not published | 0 |
| Sterile water/saline, 500 ml HCPCS A4217 | $12.17 | $31.20 | not published | 0 |
| Sternal debridement CPT 21627 | not published | not published | $6,389.00 – $15,026.00 | 2 |
| St evaluate speech sound production CPT 92522 | $244.14 | $626.00 | not published | 0 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $334.23 | $857.00 | not published | 0 |
| Stimulants synthetic CPT 80371 | not published | not published | $29.32 – $29.32 | 1 |
| Stimulation of spinal cord CPT 63610 | not published | not published | $1,308.00 – $5,449.92 | 5 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $982.80 | $2,520.00 | $713.31 – $1,187.81 | 4 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $65.18 – $482.12 | 3 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $65.18 – $482.12 | 3 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $65.18 – $482.12 | 3 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $65.18 – $482.12 | 3 |
| Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 | not published | not published | $5,063.00 – $5,063.00 | 1 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $392.34 | $1,006.00 | $444.76 – $5,063.00 | 3 |
| Strapping of chest CPT 29200 | $365.43 | $937.00 | $444.76 – $5,063.00 | 3 |
| Strapping of elbow or wrist 29260 CPT 29260 | $145.86 | $374.00 | $172.66 – $5,063.00 | 3 |
| Strapping of hand or finger CPT 29280 | $292.11 | $749.00 | $172.66 – $5,063.00 | 3 |
| Strapping of hip CPT 29520 | $381.81 | $979.00 | $360.57 – $5,063.00 | 3 |
| Strapping of knee CPT 29530 | $343.98 | $882.00 | $360.57 – $5,063.00 | 3 |
| Strapping of toes 29550 CPT 29550 | $183.30 | $470.00 | $172.66 – $5,063.00 | 3 |
| Strep a ag ia CPT 87430 | $81.51 | $209.00 | $21.02 – $58.16 | 4 |
| Strep a dna dir probe CPT 87650 | $96.72 | $248.00 | $35.12 – $69.37 | 4 |
| Strep a dna quant CPT 87652 | not published | not published | $73.14 – $144.49 | 4 |
| Strep b assay w/optic CPT 87802 | $46.41 | $119.00 | $21.02 – $44.05 | 4 |
| Strep b dna amp probe CPT 87653 | $51.32 | $131.59 | $61.50 – $121.41 | 4 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $151.53 – $151.53 | 1 |
| Streptokinase antibody CPT 86590 | not published | not published | $19.33 – $43.80 | 4 |
| Streptomycin injection HCPCS J3000 | not published | not published | $53.86 – $53.86 | 1 |
| Streptozocin injection HCPCS J9320 | not published | not published | $678.96 – $1,107.91 | 3 |
| Stress test pulmonary CPT 94618 | $424.32 | $1,088.00 | $360.57 – $360.57 | 1 |
| Stress tte complete CPT 93351 | $1,196.13 | $3,067.00 | not published | 0 |
| Str markers spec anal addl CPT 81266 | $1,110.72 | $2,848.00 | $365.77 – $1,054.64 | 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.