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 |
|---|---|---|---|---|
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,799.07 | $4,613.00 | $1,582.30 – $5,272.00 | 10 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $2,323.00 – $8,448.00 | 10 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $197.73 | $507.00 | $15.89 – $31.14 | 9 |
| Ghs reticulocyte count CPT 85044 | $74.49 | $191.00 | $4.31 – $8.45 | 9 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $173.94 | $446.00 | $13.91 – $27.26 | 9 |
| Ghs sedimentation rate CPT 85651 | $67.47 | $173.00 | $4.27 – $8.37 | 9 |
| Ghs semen analysis fert CPT 89320 | $311.22 | $798.00 | $12.31 – $24.13 | 9 |
| Ghs semen analysis, post-vas CPT 89300 | $32.37 | $83.00 | $9.84 – $19.29 | 9 |
| Ghs sensitivity (per antimicro) CPT 87184 | $83.46 | $214.00 | $7.48 – $14.66 | 9 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $741.00 | $1,900.00 | $400.02 – $2,665.00 | 10 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $741.00 | $1,900.00 | $400.02 – $2,665.00 | 10 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $741.00 | $1,900.00 | $400.02 – $2,665.00 | 10 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $741.00 | $1,900.00 | $400.02 – $2,665.00 | 10 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $741.00 | $1,900.00 | $197.43 – $2,665.00 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $741.00 | $1,900.00 | $197.43 – $2,665.00 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $741.00 | $1,900.00 | $197.43 – $2,665.00 | 9 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $741.00 | $1,900.00 | $197.43 – $2,665.00 | 10 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $741.00 | $1,900.00 | $197.43 – $2,665.00 | 10 |
| Ghs sleep study unattended CPT 95800 | $430.95 | $1,105.00 | $212.47 – $416.45 | 8 |
| Ghs somatosensory testing lower extremit CPT 95926 | $2,308.02 | $5,918.00 | $212.47 – $416.45 | 8 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $3,985.41 | $10,219.00 | $845.02 – $1,656.24 | 8 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $114.66 | $294.00 | $48.22 – $94.51 | 8 |
| Ghs sphenopalatine ganglion block CPT 64505 | $783.90 | $2,010.00 | $302.05 – $2,665.00 | 9 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $130.92 – $256.61 | 8 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $115.05 | $295.00 | $103.59 – $203.04 | 8 |
| Ghs st - eval for alt comm CPT 92567 | $157.95 | $405.00 | $36.75 – $72.04 | 8 |
| Ghs strapping shoulder - 29240 CPT 29240 | $304.59 | $781.00 | $130.92 – $2,665.00 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | $193.44 | $496.00 | $68.10 – $133.48 | 8 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $58.89 | $151.00 | $46.08 – $90.31 | 8 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $266.37 | $683.00 | $209.30 – $410.24 | 8 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,579.89 | $4,051.00 | $727.26 – $2,665.00 | 10 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $1,232.79 | $3,161.00 | $400.02 – $2,665.00 | 10 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $3,304.08 | $8,472.00 | $1,308.00 – $5,272.00 | 10 |
| Ghs trypsin (fecal) CPT 84488 | $21.84 | $56.00 | $7.30 – $14.31 | 9 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $900.51 | $2,309.00 | $242.73 – $2,665.00 | 9 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $806.13 | $2,067.00 | $242.73 – $2,665.00 | 9 |
| Ghs urine, hydroxproline total CPT 83505 | $157.56 | $404.00 | $24.30 – $47.63 | 9 |
| Ghs urine, porphyrins quant CPT 84120 | $207.48 | $532.00 | $14.71 – $28.83 | 9 |
| Ghs vaginal delivery only CPT 59409 | $5,171.40 | $13,260.00 | $3,185.40 – $6,243.39 | 9 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $2,176.59 | $5,581.00 | $367.20 – $719.70 | 8 |
| Ghs windowing of cast CPT 29730 | $184.86 | $474.00 | $159.90 – $2,665.00 | 9 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $26.68 | 9 |
| Giardia lamblia antibody CPT 86674 | $281.58 | $722.00 | $14.72 – $28.85 | 9 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $141.46 – $549.85 | 9 |
| Gi inhouse confirmation CPT 87045 | $134.16 | $344.00 | $9.44 – $18.50 | 9 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $3,262.48 – $11,889.00 | 9 |
| Gi protein loss CPT 78282 | not published | not published | $132.45 – $912.45 | 9 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,224.91 | $8,269.00 | $892.49 – $5,272.00 | 9 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $915.10 – $1,793.59 | 8 |
| Gi trc img intral esophagus CPT 91111 | $1,545.57 | $3,963.00 | $892.49 – $5,272.00 | 9 |
| Gi wireless capsule measure CPT 91112 | $1,049.49 | $2,691.00 | $892.49 – $5,272.00 | 9 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $198.20 | 9 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $120.58 | 9 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $68.60 | 9 |
| Glassia injection HCPCS J0257 | not published | not published | $5.64 – $13.17 | 9 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $28.46 – $55.78 | 8 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $36.75 – $72.04 | 8 |
| Glaucoma surgery CPT 66150 | not published | not published | $2,323.00 – $7,972.06 | 10 |
| Glaucoma surgery CPT 66155 | not published | not published | $2,323.00 – $7,972.06 | 10 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,694.00 – $6,179.00 | 10 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,270.95 – $6,179.00 | 10 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $182.45 – $449.81 | 9 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $148.99 – $292.02 | 8 |
| Glucagon plasma - sendout CPT 82943 | $205.92 | $528.00 | $14.29 – $28.01 | 9 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $46.07 – $90.30 | 9 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $50.50 – $98.98 | 9 |
| Glucagon tolerance test CPT 82946 | not published | not published | $17.77 – $34.83 | 9 |
| Glucose 1 hr post dose CPT 82950 | $77.61 | $199.00 | $4.75 – $9.31 | 9 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.05 – $11.86 | 9 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $5.46 | $14.00 | $3.28 – $6.43 | 9 |
| Glucose blood quantitative CPT 82947 | $83.85 | $215.00 | $3.93 – $7.70 | 9 |
| Glucose body fluid CPT 82945 | $140.01 | $359.00 | $3.93 – $7.70 | 9 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $73.32 | $188.00 | $58.05 – $113.78 | 8 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $189.54 | $486.00 | $12.87 – $25.23 | 9 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $48.36 | $124.00 | $3.92 – $7.68 | 9 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $1.11 – $1.11 | 1 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $57.47 – $57.47 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $11.04 – $39.78 | 9 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $219.18 | $562.00 | $18.58 – $36.42 | 9 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $290.88 | 9 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $253.11 | $649.00 | $18.52 – $36.30 | 9 |
| Gonioscopy CPT 92020 | $145.86 | $374.00 | $130.92 – $256.61 | 8 |
| Goniotomy CPT 65820 | not published | not published | $1,308.00 – $7,972.06 | 10 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $733.66 – $1,456.55 | 9 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $58.09 – $240.01 | 8 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $122.46 – $240.01 | 8 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $17,618.72 | $45,176.20 | $122.46 – $240.01 | 8 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,937.00 – $8,448.00 | 10 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $59.30 – $240.01 | 8 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $1,454.05 – $1,454.05 | 1 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $24,646.06 | $63,195.03 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $44,279.60 | $113,537.43 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $122.46 – $240.01 | 8 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,413.85 | $3,625.26 | $122.46 – $240.01 | 8 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $5,089.62 | $13,050.32 | $122.46 – $240.01 | 8 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $208.78 | $535.34 | $92.35 – $240.01 | 8 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $122.46 – $240.01 | 8 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $122.46 – $240.01 | 8 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $55,695.63 | $142,809.30 | 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.