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 |
|---|---|---|---|---|
| Tbp gene detc abnor alleles CPT 81344 | $225.42 | $578.00 | $164.40 – $474.02 | 3 |
| Tbs techl calculation only CPT 77091 | not published | not published | $256.49 – $256.49 | 1 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $256.49 – $256.49 | 1 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $115.05 | $295.00 | $104.66 – $346.00 | 4 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $123.24 | $316.00 | $108.59 – $214.45 | 4 |
| Tc-99m apcitide diag HCPCS A9504 | $2,081.04 | $5,336.00 | $784.05 – $784.05 | 1 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $1,883.62 – $1,883.62 | 1 |
| Tc-99m bicisate HCPCS A9557 | $1,357.59 | $3,481.00 | $7,127.77 – $7,127.77 | 1 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $1,256.28 – $1,256.28 | 1 |
| Tc-99m diag per dose HCPCS A4641 | $226.98 | $582.00 | not published | 0 |
| Tc-99m disofenin HCPCS A9510 | $151.32 | $388.00 | $136.09 – $136.09 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $1,304.16 | $3,344.00 | $3,332.16 – $3,332.16 | 1 |
| Tc-99m exametazime diag HCPCS A9521 | $2,166.26 | $5,554.50 | $3,332.16 – $3,332.16 | 1 |
| Tc-99m fanolesomab diag HCPCS A9566 | $2,860.65 | $7,335.00 | not published | 0 |
| Tc-99m gluceptate HCPCS A9550 | $1,338.87 | $3,433.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $186.42 | $478.00 | $181.58 – $181.58 | 1 |
| Tc-99m maa HCPCS A9540 | $396.63 | $1,017.00 | $58.32 – $58.32 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | $255.84 | $656.00 | $107.54 – $107.54 | 1 |
| Tc-99m medronate HCPCS A9503 | $122.46 | $314.00 | $25.27 – $25.27 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $387.66 | $994.00 | not published | 0 |
| Tc-99m non-heu per study dose HCPCS Q9969 | not published | not published | $26.50 – $29.93 | 2 |
| Tc-99m oxidronate HCPCS A9561 | $80.73 | $207.00 | $85.54 – $85.54 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | $95.94 | $246.00 | $60.92 – $60.92 | 1 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $123.24 | $316.00 | $33.01 – $33.01 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $85.97 | $220.44 | $3.30 – $3.30 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $128.31 | $329.00 | $124.52 – $124.52 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $387.66 | $994.00 | $178.73 – $178.73 | 1 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $1,578.33 | $4,047.00 | $1,165.35 – $1,165.35 | 1 |
| Tc-99m sulfur colloid HCPCS A9541 | $169.26 | $434.00 | $519.79 – $519.79 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $212.94 | $546.00 | $165.78 – $165.78 | 1 |
| Tc-99m tilmanocept diag HCPCS A9520 | $930.54 | $2,386.00 | $1,286.19 – $1,286.19 | 1 |
| Tca peel dermal 15789 CPT 15789 | $2,531.49 | $6,491.00 | $1,772.77 – $5,063.00 | 3 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $310.32 – $1,389.14 | 2 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $310.32 – $1,287.77 | 2 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $691.66 – $1,145.91 | 2 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $1,225.32 – $5,063.00 | 4 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $313.20 | $803.07 | $82.32 – $162.55 | 4 |
| T cells absolute cd 4 count CPT 86361 | $182.91 | $469.00 | $46.91 – $92.66 | 4 |
| T cells total count CPT 86359 | $145.86 | $374.00 | $66.10 – $130.55 | 4 |
| Tcranial magn stim tx deli CPT 90868 | $389.22 | $998.00 | $885.97 – $885.97 | 1 |
| Tcranial magn stim tx plan CPT 90867 | $386.88 | $992.00 | $885.97 – $885.97 | 1 |
| Tcran magn stim redetemine CPT 90869 | $386.88 | $992.00 | $885.97 – $885.97 | 1 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $409.33 – $722.90 | 2 |
| Telavancin injection HCPCS J3095 | not published | not published | $14.10 – $24.39 | 3 |
| Telehealth original site facility fee HCPCS Q3014 | $71.37 | $183.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $1,526.85 | $3,915.00 | $321.94 – $1,042.95 | 4 |
| Telethx isodose plan simple CPT 77306 | $1,368.51 | $3,509.00 | $178.14 – $1,042.95 | 4 |
| Temozolomide HCPCS J8700 | not published | not published | $0.51 – $0.51 | 1 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $19.84 – $35.98 | 3 |
| Temperature gradient studies CPT 93740 | not published | not published | $440.91 – $440.91 | 1 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $5,063.00 – $7,487.00 | 2 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $56.27 – $107.23 | 3 |
| Tendon lengthening CPT 26476 | not published | not published | $1,308.00 – $9,136.47 | 5 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $2,323.00 – $9,136.47 | 5 |
| Tendon shortening CPT 26477 | not published | not published | $1,308.00 – $9,136.47 | 5 |
| Tendon transfer with graft CPT 26492 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $309.59 – $529.76 | 3 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $4,852.43 – $7,011.13 | 2 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $1,937.00 – $9,136.47 | 5 |
| Tenolysis triceps CPT 24332 | not published | not published | $4,220.00 – $9,136.47 | 4 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $1,937.00 – $20,193.44 | 5 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,937.00 – $5,809.00 | 5 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $5,809.00 – $15,026.00 | 2 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $1,694.00 – $9,136.47 | 5 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $4,536.58 – $6,179.00 | 3 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | not published | not published | $4.08 – $4.08 | 1 |
| Teriparatide injection HCPCS J3110 | not published | not published | $97.85 – $97.85 | 1 |
| Tert gene targeted seq alys CPT 81345 | $304.59 | $781.00 | $222.24 – $640.79 | 3 |
| Test for chlorohydrocarbons CPT 82441 | $866.97 | $2,223.00 | $10.51 – $20.79 | 4 |
| Test for porphobilinogen CPT 84106 | $77.22 | $198.00 | $7.50 – $20.14 | 4 |
| Test for urine cystines CPT 82615 | $139.62 | $358.00 | $14.30 – $33.04 | 4 |
| Testicular imaging w/vasc flow CPT 78761 | $296.40 | $760.00 | $426.52 – $1,164.18 | 4 |
| Testosterone pellet 75 mg HCPCS S0189 | not published | not published | $204.40 – $204.40 | 1 |
| Testosterone response panel CPT 80414 | not published | not published | $73.05 – $178.67 | 4 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $3.66 – $6.37 | 3 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $59.67 | $153.00 | $30.60 – $172.66 | 3 |
| Test stress cardiovascular tracing only CPT 93017 | $1,275.30 | $3,270.00 | $885.97 – $885.97 | 1 |
| Test urine for lactose CPT 83633 | not published | not published | $9.65 – $38.92 | 4 |
| Test urine for porphyrins CPT 84119 | $66.30 | $170.00 | $15.08 – $46.23 | 4 |
| Test urine urobilinogen CPT 84578 | $9.75 | $25.00 | $5.69 – $15.47 | 4 |
| Tetanus ig im CPT 90389 | not published | not published | $1,385.80 – $1,385.80 | 1 |
| Tetanus immune globulin inj HCPCS J1670 | not published | not published | $1,090.37 – $2,001.99 | 3 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | not published | not published | $34.61 – $64.32 | 2 |
| Tgfbi gene common variants CPT 81333 | $225.42 | $578.00 | $164.40 – $474.02 | 3 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $2,627.97 – $2,627.97 | 1 |
| Tgsap so/hl 51/< rna alys CPT 81456 | $4,563.00 | $11,700.00 | $10,101.82 – $10,101.82 | 1 |
| Tgsap so neo 5-50 rna alys CPT 81449 | $816.27 | $2,093.00 | $2,068.77 – $2,068.77 | 1 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $65.18 – $482.12 | 3 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $65.18 – $482.12 | 3 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $65.18 – $482.12 | 3 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $65.18 – $152.95 | 3 |
| Thaw preserved stem cells CPT 38208 | $652.08 | $1,672.00 | $1,225.32 – $5,063.00 | 4 |
| Theophylline therapeutic drug level CPT 80198 | $123.24 | $316.00 | $24.79 – $48.92 | 4 |
| Therapeutic procd strg endur HCPCS G0237 | $53.82 | $138.00 | $84.05 – $84.05 | 1 |
| Therapeutic pulpotomy HCPCS D3220 | not published | not published | $1,694.00 – $2,485.25 | 2 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $78.39 | $201.00 | not published | 0 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $88.14 | $226.00 | not published | 0 |
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.