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 |
|---|---|---|---|---|
| Str markers specimen anal CPT 81265 | $1,477.32 | $3,788.00 | $352.06 – $806.42 | 4 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $1,952.00 – $4,066.00 | 4 |
| Subq njx filling matrl 1cc/< CPT 11950 | $136.50 | $350.00 | $565.10 – $5,063.00 | 3 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $1,772.77 – $5,063.00 | 3 |
| Subsequent repair of nerve CPT 64872 | not published | not published | $1,694.00 – $4,714.00 | 3 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $5,809.00 – $9,136.47 | 4 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $5,809.00 – $20,193.44 | 4 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $5,809.00 – $9,136.47 | 4 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $5,809.00 – $37,149.33 | 4 |
| Subtemporal cranial dcmprn CPT 61340 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | not published | not published | $1.56 – $1.56 | 1 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $1,937.00 – $10,126.62 | 5 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $1,937.00 – $10,126.62 | 5 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $1,937.00 – $10,126.62 | 5 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $1,937.00 – $5,809.00 | 5 |
| Sugars multiple quant CPT 84379 | not published | not published | $20.20 – $39.89 | 4 |
| Sugars single quant CPT 84378 | not published | not published | $20.20 – $39.89 | 4 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $29.66 – $29.66 | 1 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | not published | not published | $95.26 – $95.26 | 1 |
| Supprelin la implant HCPCS J9226 | not published | not published | $86,268.99 – $154,232.75 | 3 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $1,694.00 – $7,925.42 | 5 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $5,809.00 – $8,448.00 | 2 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $2,664.00 – $8,448.00 | 3 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $1,694.00 – $9,840.21 | 5 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $6,389.00 – $20,193.44 | 3 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $6,760.00 – $20,193.44 | 3 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $6,389.00 – $20,193.44 | 3 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $6,760.00 – $20,193.44 | 3 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $1,937.00 – $14,605.40 | 4 |
| Surgical opening esophagus CPT 43351 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgical opening esophagus CPT 43352 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgical opening of stomach CPT 43510 | not published | not published | $2,558.69 – $5,272.00 | 3 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgical opening of throat CPT 42955 | not published | not published | $1,694.00 – $5,272.00 | 5 |
| Surgical pathology level 1 gross examination only CPT 88300 | $135.33 | $347.00 | $13.34 – $84.05 | 4 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $175.11 | $449.00 | $19.80 – $84.05 | 4 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $270.27 | $693.00 | $41.46 – $152.95 | 4 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $328.38 | $842.00 | $41.46 – $152.95 | 4 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $311.22 | $798.00 | $65.18 – $1,014.60 | 4 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $352.56 | $904.00 | $65.18 – $2,427.15 | 4 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgical revision intestine CPT 44680 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $162.01 – $162.01 | 1 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $1,308.00 – $7,925.42 | 5 |
| Susceptibility agar dilution per agent CPT 87181 | $39.78 | $102.00 | $8.32 – $16.43 | 4 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $51.09 | $131.00 | $8.32 – $16.43 | 4 |
| Susceptibility mic per plate CPT 87186 | $94.38 | $242.00 | $15.14 – $29.93 | 4 |
| Suscept studies macrobroth dilution ea CPT 87188 | $663.78 | $1,702.00 | $11.63 – $22.97 | 4 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Suspension of testis CPT 54620 | not published | not published | $1,937.00 – $9,840.21 | 5 |
| Suspension of uterus CPT 58410 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $6,760.00 – $8,448.00 | 2 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Svc venogram s&i CPT 75827 | $2,159.43 | $5,537.00 | $188.75 – $4,520.58 | 4 |
| Swallowing Evaluation (Bedside) CPT 92610 | $244.14 | $626.00 | not published | 0 |
| Swallowing Therapy Session CPT 92526 | $129.87 | $333.00 | not published | 0 |
| Sweat collection by iontophoresis CPT 89230 | $290.94 | $746.00 | $3.08 – $152.95 | 4 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,694.00 – $5,449.92 | 5 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $5,063.00 – $6,179.00 | 3 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,437.00 – $9,136.47 | 4 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $16.96 – $47.75 | 3 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $17.46 – $31.56 | 3 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $49.14 | $126.00 | $7.72 – $15.22 | 4 |
| System cardiomems hosp electronics HCPCS C2624 | $36,449.60 | $93,460.50 | not published | 0 |
| System pacing micra av HCPCS C1786 | $49,463.68 | $126,829.94 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $12,193.46 | $31,265.28 | not published | 0 |
| System sealant biosentry tract HCPCS C2613 | $616.09 | $1,579.72 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $239.07 | $613.00 | $29.69 – $58.61 | 4 |
| T3 (triiodothyronine) total CPT 84480 | $161.85 | $415.00 | $24.84 – $49.06 | 4 |
| T4 (thyroxine) free CPT 84439 | $137.67 | $353.00 | $15.80 – $31.21 | 4 |
| T4 (thyroxine) total CPT 84436 | $96.72 | $248.00 | $12.04 – $23.77 | 4 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $1.09 – $1.09 | 1 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $3.43 – $3.43 | 1 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.34 – $0.34 | 1 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $485.40 – $860.64 | 3 |
| Tacrolimus therapeutic drug level CPT 80197 | $218.40 | $560.00 | $24.05 – $47.51 | 4 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $26.63 – $47.06 | 3 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $6,859.00 – $9,000.00 | 2 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $287.04 | $736.00 | $44.14 – $256.49 | 4 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $134.13 – $230.40 | 3 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $133.36 – $133.36 | 1 |
| Talymed HCPCS Q4127 | not published | not published | $130.54 – $130.54 | 1 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $0.38 – $0.38 | 1 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $2,665.00 – $4,714.00 | 2 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $2,665.00 – $4,714.00 | 2 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,819.70 | $7,230.00 | $107.80 – $2,627.97 | 3 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $2,744.04 | $7,036.00 | $3,503.52 – $10,101.82 | 3 |
| Target gsa panel organ neop CPT 81445 | $3,296.28 | $8,452.00 | $107.80 – $2,068.77 | 3 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $2,916.18 – $2,916.18 | 1 |
| Tas congenital car anomal CPT 33741 | $6,003.27 | $15,393.00 | $6,859.00 – $6,859.00 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $1,772.77 – $3,391.00 | 3 |
| Tavr perq femoral CPT 33361 | $13,308.36 | $34,124.00 | $5,063.00 – $6,859.00 | 2 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.76 – $1.52 | 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.