Wellstar Roosevelt Long Term Acute Care at Warm Springs
6135 Roosevelt Highway, P O Box 280, GA · Wellstar Health System · · NPI 1427468362
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 superficial wnd dehis w packing12021 CPT 12021 | $1,232.79 | $3,161.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $3,304.08 | $8,472.00 | not published | 0 |
| Ghs trypsin (fecal) CPT 84488 | $21.84 | $56.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $900.51 | $2,309.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $806.13 | $2,067.00 | not published | 0 |
| Ghs urine, hydroxproline total CPT 83505 | $157.56 | $404.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $207.48 | $532.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $5,171.40 | $13,260.00 | not published | 0 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $2,176.59 | $5,581.00 | not published | 0 |
| Ghs windowing of cast CPT 29730 | $184.86 | $474.00 | not published | 0 |
| Giardia lamblia antibody CPT 86674 | $281.58 | $722.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $134.16 | $344.00 | not published | 0 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,224.91 | $8,269.00 | not published | 0 |
| Gi trc img intral esophagus CPT 91111 | $1,545.57 | $3,963.00 | not published | 0 |
| Gi wireless capsule measure CPT 91112 | $1,049.49 | $2,691.00 | not published | 0 |
| Glucagon plasma - sendout CPT 82943 | $205.92 | $528.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $77.61 | $199.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $5.46 | $14.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $83.85 | $215.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $140.01 | $359.00 | not published | 0 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $73.32 | $188.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $189.54 | $486.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $48.36 | $124.00 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $219.18 | $562.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $253.11 | $649.00 | not published | 0 |
| Gonioscopy CPT 92020 | $145.86 | $374.00 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $17,618.72 | $45,176.20 | not published | 0 |
| 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 puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,413.85 | $3,625.26 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $5,089.62 | $13,050.32 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $208.78 | $535.34 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $55,695.63 | $142,809.30 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $25,834.81 | $66,243.10 | not published | 0 |
| Granulocyte pheresis ea unit HCPCS P9050 | $1,967.55 | $5,045.00 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $900.51 | $2,309.00 | not published | 0 |
| Grfg autol soft tiss dir exc CPT 15769 | $4,128.93 | $10,587.00 | not published | 0 |
| Ground mileage HCPCS A0425 | $17.55 | $45.00 | not published | 0 |
| Growth stimulation gene 2 CPT 83006 | $223.47 | $573.00 | not published | 0 |
| G-tube reposition CPT 43761 | $4,334.85 | $11,115.00 | not published | 0 |
| Gu dilat ureter/urethra s&i CPT 74485 | $821.73 | $2,107.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $7,100.34 | $18,206.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,531.94 | $9,056.25 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $945.75 | $2,425.00 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $1,051.44 | $2,696.00 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $13,326.50 | $34,170.52 | not published | 0 |
| Hand-held pefr meter a4614 HCPCS A4614 | $33.10 | $84.87 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $6,104.40 | $15,652.30 | not published | 0 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $97.50 | $250.00 | not published | 0 |
| Hand X-ray CPT 73130 | $264.42 | $678.00 | not published | 0 |
| Hand X-ray (2 views, both hands) CPT 73120 | $237.90 | $610.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $235.17 | $603.00 | not published | 0 |
| Harvest auto stem cells CPT 38206 | $4,212.00 | $10,800.00 | not published | 0 |
| Harvest stem cell concentrte CPT 38215 | $1,287.78 | $3,302.00 | not published | 0 |
| Hast w/oxygen titrate CPT 94453 | $154.05 | $395.00 | not published | 0 |
| Hba1/hba2 full gene sequence CPT 81259 | $847.86 | $2,174.00 | not published | 0 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $190.32 | $488.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $459.42 | $1,178.00 | not published | 0 |
| Hbb gene com variants CPT 81361 | $228.54 | $586.00 | not published | 0 |
| Hbb gene dup/del variants CPT 81363 | $228.54 | $586.00 | not published | 0 |
| Hbot, full body chamber, 30m HCPCS G0277 | $969.54 | $2,486.00 | not published | 0 |
| Hc ea ha check monaural CPT 92594 | $35.10 | $90.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $759.72 | $1,948.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $173.16 | $444.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $182.52 | $468.00 | not published | 0 |
| Hc hearing aid chck binaurl CPT 92593 | $55.77 | $143.00 | not published | 0 |
| Hc hearing aid chck monarl CPT 92592 | $35.10 | $90.00 | not published | 0 |
| Hc hearing aid exam both ears CPT 92591 | $98.67 | $253.00 | not published | 0 |
| Hc hearing aid exam one ear CPT 92590 | $48.36 | $124.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $459.22 | $1,177.50 | not published | 0 |
| Hc metata joint dislocation anes CPT 28635 | $8,713.38 | $22,342.00 | not published | 0 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | $577.98 | $1,482.00 | not published | 0 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | $584.61 | $1,499.00 | not published | 0 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | $730.08 | $1,872.00 | not published | 0 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | $366.60 | $940.00 | not published | 0 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | $617.76 | $1,584.00 | not published | 0 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $645.06 | $1,654.00 | not published | 0 |
| Hc nm fusion spect CT unlisted CPT 78999 | $239.85 | $615.00 | not published | 0 |
| Hc nm kidney imaging with flow CPT 78701 | $755.43 | $1,937.00 | not published | 0 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $834.21 | $2,139.00 | not published | 0 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,460.12 | $6,308.00 | not published | 0 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $6,654.57 | $17,063.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $3,781.83 | $9,697.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $4,046.25 | $10,375.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $4,184.70 | $10,730.00 | not published | 0 |
| Hdr rdncl skn surf brachytx CPT 77767 | $1,545.18 | $3,962.00 | not published | 0 |
| Hdr rdncl skn surf brachytx CPT 77768 | $2,264.34 | $5,806.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $1,881.36 | $4,824.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $1,587.69 | $4,071.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $1,418.82 | $3,638.00 | not published | 0 |
| Heart first pass add-on CPT 78496 | $176.28 | $452.00 | not published | 0 |
| Heart image spect CPT 78494 | $497.25 | $1,275.00 | not published | 0 |
| Heart infarct image (ef) CPT 78468 | $714.87 | $1,833.00 | not published | 0 |
| Heavy metal qual any number CPT 83015 | $331.89 | $851.00 | not published | 0 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $230.10 | $590.00 | not published | 0 |
| Heinz bodies direct CPT 85441 | $107.64 | $276.00 | not published | 0 |
| Helicobacter pylori antibody igm CPT 86677 | $141.57 | $363.00 | not published | 0 |
| Hematocrit CPT 85014 | $34.32 | $88.00 | not published | 0 |
| Hematopoietic nuclear tx CPT 79403 | $928.98 | $2,382.00 | not published | 0 |
| Hemoglobin CPT 85018 | $34.71 | $89.00 | 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.