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 |
|---|---|---|---|---|
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $311.22 | $798.00 | $65.18 – $691.33 | 9 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $352.56 | $904.00 | $65.18 – $1,553.90 | 9 |
| 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 | $122.46 – $240.01 | 8 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $1,308.00 – $6,179.00 | 10 |
| Susceptibility agar dilution per agent CPT 87181 | $39.78 | $102.00 | $4.75 – $9.31 | 9 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $51.09 | $131.00 | $4.75 – $9.31 | 9 |
| Susceptibility mic per plate CPT 87186 | $94.38 | $242.00 | $8.65 – $16.95 | 9 |
| Suscept studies macrobroth dilution ea CPT 87188 | $663.78 | $1,702.00 | $6.64 – $13.01 | 9 |
| 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 – $6,798.57 | 10 |
| 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 – $3,036.04 | 9 |
| Swallowing Evaluation (Bedside) CPT 92610 | $244.14 | $626.00 | $58.21 – $114.09 | 8 |
| Swallowing Therapy Session CPT 92526 | $129.87 | $333.00 | $80.01 – $156.82 | 8 |
| Sweat collection by iontophoresis CPT 89230 | $290.94 | $746.00 | $3.08 – $100.51 | 9 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,694.00 – $5,272.00 | 10 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $1,921.52 – $6,179.00 | 9 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $5,063.00 – $6,859.00 | 2 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,219.72 – $8,448.00 | 9 |
| 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 |
| Synthetic sentence id test CPT 92576 | not published | not published | $36.75 – $72.04 | 8 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $7.95 – $27.67 | 9 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $49.14 | $126.00 | $4.40 – $8.62 | 9 |
| 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 | $16.94 – $33.20 | 9 |
| T3 (triiodothyronine) total CPT 84480 | $161.85 | $415.00 | $14.18 – $27.79 | 9 |
| T4 (thyroxine) free CPT 84439 | $137.67 | $353.00 | $9.02 – $17.68 | 9 |
| T4 (thyroxine) total CPT 84436 | $96.72 | $248.00 | $6.87 – $13.47 | 9 |
| 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 | $263.15 – $582.23 | 9 |
| Tacrolimus therapeutic drug level CPT 80197 | $218.40 | $560.00 | $13.73 – $26.91 | 9 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $14.31 – $33.87 | 9 |
| 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 – $167.84 | 9 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $73.94 – $151.50 | 9 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $72.62 – $142.33 | 8 |
| Talymed HCPCS Q4127 | not published | not published | $122.46 – $240.01 | 8 |
| 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 – $1,488.68 | 9 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $2,744.04 | $7,036.00 | $2,919.60 – $5,722.42 | 9 |
| Target gsa panel organ neop CPT 81445 | $3,296.28 | $8,452.00 | $107.80 – $1,171.90 | 9 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,564.64 – $3,066.69 | 8 |
| 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 | $727.26 – $2,665.00 | 9 |
| 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 | $0.28 – $1.17 | 9 |
| Tbp gene detc abnor alleles CPT 81344 | $225.42 | $578.00 | $137.00 – $268.52 | 9 |
| Tbs techl calculation only CPT 77091 | not published | not published | $85.63 – $167.84 | 8 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $85.63 – $167.84 | 8 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $115.05 | $295.00 | $100.00 – $196.00 | 9 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $123.24 | $316.00 | $61.98 – $121.48 | 9 |
| 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 | $775.52 – $1,520.02 | 8 |
| 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 | $934.13 – $1,830.89 | 8 |
| Tc-99m exametazime diag HCPCS A9521 | $2,166.26 | $5,554.50 | $927.71 – $1,818.31 | 8 |
| 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 – $34.60 | 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 | $659.93 – $1,293.46 | 8 |
| 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 | $727.26 – $2,665.00 | 9 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $102.88 – $201.64 | 8 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $102.88 – $201.64 | 8 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $1,145.91 – $1,145.91 | 1 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $434.13 – $2,665.00 | 9 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $313.20 | $803.07 | $46.98 – $92.08 | 9 |
| T cells absolute cd 4 count CPT 86361 | $182.91 | $469.00 | $26.78 – $52.49 | 9 |
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.