Wellstar West Georgia Medical Center
1514 Vernon Road, Lagrange, GA · Wellstar Health System · · NPI 1821221144
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 |
|---|---|---|---|---|
| Unlisted px mediastinum CPT 39499 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Unlisted px med radj physics CPT 77399 | not published | not published | $132.26 – $259.23 | 8 |
| Unlisted px middle ear CPT 69799 | not published | not published | $233.07 – $2,665.00 | 9 |
| Unlisted px neck/thorax CPT 21899 | not published | not published | $233.07 – $2,665.00 | 9 |
| Unlisted px palate uvula CPT 42299 | not published | not published | $233.07 – $2,665.00 | 9 |
| Unlisted px pelvis/hip joint CPT 27299 | not published | not published | $242.73 – $2,665.00 | 9 |
| Unlisted px posterior segmnt CPT 67299 | not published | not published | $2,270.95 – $5,272.00 | 9 |
| Unlisted px salivry glnd/dux CPT 42699 | not published | not published | $233.07 – $2,665.00 | 9 |
| Unlisted px small intestine CPT 44799 | not published | not published | $892.49 – $5,272.00 | 9 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $233.07 – $2,665.00 | 9 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $132.26 – $259.23 | 8 |
| Unlisted px tongue flr mouth CPT 41599 | $1,553.76 | $3,984.00 | $233.07 – $2,665.00 | 9 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $233.07 – $2,665.00 | 9 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $12.50 – $100.51 | 9 |
| Unlisted resp px dx nuc med CPT 78599 | $545.61 | $1,399.00 | $393.38 – $771.03 | 8 |
| Unlisted spec derm svc/px CPT 96999 | $173.55 | $445.00 | $197.43 – $386.96 | 8 |
| Unlisted surgical path px CPT 88399 | $439.92 | $1,128.00 | $12.07 – $100.51 | 9 |
| Unlisted transfusion med px CPT 86999 | $698.10 | $1,790.00 | $17.39 – $55.78 | 9 |
| Unlisted ultrasound procedure CPT 76999 | $291.33 | $747.00 | $85.63 – $167.84 | 8 |
| Unlisted urinalysis px CPT 81099 | $29.64 | $76.00 | $28.70 – $28.70 | 1 |
| Unlisted vasc endoscopy px CPT 37501 | not published | not published | $617.28 – $4,066.00 | 9 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $393.38 – $771.03 | 8 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $5,809.00 – $11,889.00 | 9 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $5,809.00 – $11,889.00 | 9 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $4,701.06 | $12,054.00 | $675.35 – $1,323.68 | 8 |
| Upgrade pm system CPT 33214 | $5,840.64 | $14,976.00 | $9,000.00 – $34,203.00 | 9 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $235.17 | $603.00 | $47.40 – $167.84 | 9 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $1,748.37 | $4,483.00 | $172.60 – $338.29 | 8 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $1,577.16 | $4,044.00 | $102.88 – $201.64 | 8 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,429.31 | $6,229.00 | $343.30 – $672.87 | 8 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,001.87 | $5,133.00 | $343.30 – $672.87 | 8 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,762.41 | $4,519.00 | $234.79 – $460.19 | 8 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $324.48 | $832.00 | $52.31 – $201.64 | 9 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $384.93 | $987.00 | $53.93 – $201.64 | 9 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $892.49 – $5,272.00 | 10 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $1,405.56 | $3,604.00 | $892.49 – $5,272.00 | 10 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $738.66 | $1,894.00 | $172.60 – $350.42 | 9 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $491.01 | $1,259.00 | $172.60 – $338.29 | 9 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $892.49 – $5,272.00 | 10 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $2,323.00 – $11,659.90 | 10 |
| Urea nitrogen CPT 84520 | $58.50 | $150.00 | $3.95 – $7.74 | 9 |
| Urea nitrogen 24 hour urine CPT 84540 | $81.12 | $208.00 | $5.56 – $10.90 | 9 |
| Urea nitrogen clearance CPT 84545 | $163.80 | $420.00 | $7.20 – $14.11 | 9 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $5.13 – $10.05 | 9 |
| Ureteral embolization/occl CPT 50705 | $3,041.22 | $7,798.00 | $2,665.00 – $3,391.00 | 2 |
| Ureteral reflux study CPT 78740 | $694.20 | $1,780.00 | $393.38 – $771.03 | 9 |
| Ureter endoscopy CPT 50970 | not published | not published | $1,308.00 – $6,798.57 | 10 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $1,308.00 – $10,341.20 | 10 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $1,308.00 – $10,341.20 | 10 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $1,308.00 – $6,798.57 | 10 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $1,308.00 – $10,341.20 | 10 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $1,308.00 – $10,341.20 | 10 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $1,308.00 – $10,341.20 | 10 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $1,308.00 – $10,341.20 | 10 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $5,063.00 – $6,179.00 | 2 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $253.50 | $650.00 | $128.37 – $744.45 | 9 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,468.66 – $8,448.00 | 9 |
| Urethrocystography void s&i CPT 74455 | $390.39 | $1,001.00 | $150.35 – $460.19 | 9 |
| Uric acid blood CPT 84550 | $74.49 | $191.00 | $4.52 – $8.86 | 9 |
| Uric acid urine CPT 84560 | $93.60 | $240.00 | $5.08 – $9.96 | 9 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $9.21 | 9 |
| Urinalysis microscopic only CPT 81015 | $49.14 | $126.00 | $3.05 – $5.98 | 9 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $46.80 | $120.00 | $2.17 – $4.25 | 9 |
| Urinalysis (with microscopy) CPT 81001 | $62.40 | $160.00 | $3.17 – $6.21 | 9 |
| Urinalysis (without microscopy) CPT 81003 | $74.88 | $192.00 | $2.25 – $4.41 | 9 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $151.16 – $278.99 | 3 |
| Urinary reflex study CPT 51792 | not published | not published | $58.05 – $2,665.00 | 9 |
| Urine Culture Test CPT 87086 | $202.80 | $520.00 | $8.07 – $15.82 | 9 |
| Urine flow measurement 51736 CPT 51736 | $274.17 | $703.00 | $130.92 – $2,665.00 | 9 |
| Urine pregnancy test CPT 81025 | $98.67 | $253.00 | $8.61 – $16.88 | 9 |
| Urine screen for bacteria CPT 81007 | not published | not published | $4.45 – $58.76 | 9 |
| Urine shunt to intestine CPT 50815 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $3.60 – $3,391.00 | 3 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $120.90 – $120.90 | 1 |
| Urography, antegrade CPT 74425 | $489.45 | $1,255.00 | $110.38 – $744.45 | 9 |
| Urography inf drip &/or bolus CPT 74410 | $599.82 | $1,538.00 | $172.60 – $338.29 | 9 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $872.43 – $872.43 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $17.46 – $17.46 | 1 |
| Use 1st target lesion CPT 76982 | $136.11 | $349.00 | $102.88 – $201.64 | 8 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $12.99 – $30.87 | 9 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $297.11 – $532.70 | 3 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $9,032.00 – $24,761.74 | 8 |
| Vaccine Administration (one shot) CPT 90471 | $62.79 | $161.00 | $70.85 – $138.87 | 8 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $302.71 – $504.88 | 2 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $275.38 – $504.88 | 2 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $291.92 – $453.61 | 2 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $164.37 – $303.72 | 2 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $122.75 – $226.80 | 2 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $61.49 – $61.49 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $209.15 – $209.15 | 1 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $130.39 – $130.39 | 1 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $334.33 – $334.33 | 1 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $256.30 – $256.30 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $65.28 – $65.28 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $25.73 – $25.73 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $173.60 – $173.60 | 1 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $269.39 – $269.39 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $81.14 – $81.14 | 1 |
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.