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 |
|---|---|---|---|---|
| Irradiation of blood product each unit reference CPT 86945 | $241.02 | $618.00 | not published | 0 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $329.16 | $844.00 | not published | 0 |
| Ivc venogram s&i CPT 75825 | $1,994.85 | $5,115.00 | not published | 0 |
| IV Fluids (each additional hour) CPT 96361 | $110.76 | $284.00 | not published | 0 |
| IV Fluids (first hour) CPT 96360 | $427.05 | $1,095.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $427.05 | $1,095.00 | not published | 0 |
| IV inj ra drug dx study CPT 78808 | $281.19 | $721.00 | not published | 0 |
| IV Medicine Infusion (additional drug) CPT 96367 | $427.05 | $1,095.00 | not published | 0 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $106.47 | $272.99 | not published | 0 |
| IV Medicine Infusion (first hour) CPT 96365 | $427.05 | $1,095.00 | not published | 0 |
| IV Push Injection (each additional drug) CPT 96375 | $191.88 | $492.00 | not published | 0 |
| IV Push Injection (first drug) CPT 96374 | $306.54 | $786.00 | not published | 0 |
| Ivp w/nephrotomography CPT 74415 | $862.29 | $2,211.00 | not published | 0 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $645.84 | $1,656.00 | not published | 0 |
| Jak2 targeted sequence analysis CPT 81279 | $601.77 | $1,543.00 | not published | 0 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $271.44 | $696.00 | not published | 0 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $384.93 | $987.00 | not published | 0 |
| John cunningham antibody CPT 86711 | $1,727.70 | $4,430.00 | not published | 0 |
| Ketogenic steroids fract CPT 83582 | $81.12 | $208.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $178.62 | $458.00 | not published | 0 |
| Kidney imaging morphology CPT 78700 | $553.80 | $1,420.00 | not published | 0 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $824.46 | $2,114.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $618.54 | $1,586.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $290.16 | $744.00 | not published | 0 |
| Kit case 4.2mm spinejack HCPCS C1062 | $7,751.14 | $19,874.72 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $8,081.88 | $20,722.77 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $170.43 | $437.00 | not published | 0 |
| Kit hfx iq ipg bundle HCPCS C1822 | $42,421.35 | $108,772.69 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $49,011.18 | $125,669.70 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $16,965.41 | $43,501.05 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,340.86 | $3,438.11 | not published | 0 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $16,851.58 | $43,209.18 | not published | 0 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,638.82 | $4,202.10 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $2,072.46 | $5,314.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $1,900.86 | $4,874.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $1,549.08 | $3,972.00 | not published | 0 |
| Knee X-ray CPT 73564 | $273.00 | $700.00 | not published | 0 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $173.55 | $445.00 | not published | 0 |
| Knee X-ray (3 views, both knees) CPT 73562 | $269.88 | $692.00 | not published | 0 |
| Knee X-ray (standing, both knees) CPT 73565 | $201.63 | $517.00 | not published | 0 |
| Kras gene addl variants CPT 81276 | $799.50 | $2,050.00 | not published | 0 |
| Kras gene variants exon 2 CPT 81275 | $598.65 | $1,535.00 | not published | 0 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $125.97 | $323.00 | not published | 0 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $23.01 | $59.00 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $95.16 | $244.00 | not published | 0 |
| Lactation class HCPCS S9443 | $176.67 | $453.00 | not published | 0 |
| Lactic acid CPT 83605 | $149.37 | $383.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $114.27 | $293.00 | not published | 0 |
| Lactoferrin fecal quant CPT 83631 | $169.26 | $434.00 | not published | 0 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $905.19 | $2,321.00 | not published | 0 |
| Largsc w/laser dstrj les CPT 31572 | $4,240.08 | $10,872.00 | not published | 0 |
| Largsc w/njx augmentation CPT 31574 | $577.98 | $1,482.00 | not published | 0 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $2,006.94 | $5,146.00 | not published | 0 |
| Largsc w/ther injection CPT 31573 | $789.36 | $2,024.00 | not published | 0 |
| Laryngeal function studies CPT 92520 | $708.63 | $1,817.00 | not published | 0 |
| Laryngoscope w/vc inj CPT 31570 | $925.47 | $2,373.00 | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $3,735.81 | $9,579.00 | not published | 0 |
| Laryngoscopy telescopic CPT 31579 | $1,844.31 | $4,729.00 | not published | 0 |
| Laryngoscopy w/biopsy CPT 31535 | $4,188.60 | $10,740.00 | not published | 0 |
| Laryngoscopy w/fb removal CPT 31530 | $4,802.46 | $12,314.00 | not published | 0 |
| Laryngoscopy with biopsy CPT 31576 | $2,340.78 | $6,002.00 | not published | 0 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $5,617.19 | $14,403.06 | not published | 0 |
| Lead capillary CPT 83655 | $114.27 | $293.00 | not published | 0 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $3,047.96 | $7,815.28 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,723.76 | $14,676.30 | not published | 0 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $708.63 | $1,817.00 | not published | 0 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,269.45 | $3,255.00 | not published | 0 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $1,167.27 | $2,993.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $984.75 | $2,525.00 | not published | 0 |
| Leishmania antibody CPT 86717 | $58.50 | $150.00 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $200.91 | $515.16 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $977.16 | $2,505.55 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $683.72 | $1,753.14 | not published | 0 |
| Leukocyte phagocytosis CPT 86344 | $218.40 | $560.00 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $155.61 | $399.00 | not published | 0 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $4,048.20 | $10,380.00 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $65,883.98 | $168,933.29 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $112.71 | $289.00 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $5,706.09 | $14,631.00 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $2,246.40 | $5,760.00 | not published | 0 |
| Limited visual field xm CPT 92081 | $73.32 | $188.00 | not published | 0 |
| Lipase CPT 83690 | $143.13 | $367.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $143.13 | $367.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $198.51 | $509.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $90.48 | $232.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $96.72 | $248.00 | not published | 0 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $83.85 | $215.00 | not published | 0 |
| Listeria monocytogenes CPT 86723 | $60.84 | $156.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $69.42 | $178.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,371.12 | $11,208.00 | not published | 0 |
| Liver elastography 91200 CPT 91200 | $258.18 | $662.00 | not published | 0 |
| Liver Function Test CPT 80076 | $115.44 | $296.00 | not published | 0 |
| Liver imaging CPT 78201 | $453.96 | $1,164.00 | not published | 0 |
| Liver imag w/vasclr flow CPT 78202 | $904.41 | $2,319.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $638.43 | $1,637.00 | not published | 0 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $727.35 | $1,865.00 | not published | 0 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $171.60 | $440.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5271 | $1,533.48 | $3,932.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5273 | $1,533.48 | $3,932.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5275 | $1,533.48 | $3,932.00 | 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.