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 |
|---|---|---|---|---|
| Low cost skin substitute app HCPCS C5277 | $1,533.48 | $3,932.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5272 | $652.86 | $1,674.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5274 | $652.86 | $1,674.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5276 | $702.00 | $1,800.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5278 | $652.86 | $1,674.00 | not published | 0 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $331.50 | $850.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,958.19 | $5,021.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,705.08 | $4,372.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,610.70 | $4,130.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,370.03 | $6,077.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,045.55 | $5,245.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,775.67 | $4,553.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $341.64 | $876.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $505.83 | $1,297.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $513.63 | $1,317.00 | not published | 0 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $238.68 | $612.00 | not published | 0 |
| Low frequency non-thermal Ultrasound CPT 97610 | $272.22 | $698.00 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | $476.19 | $1,221.00 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $667.29 | $1,711.00 | not published | 0 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $731.64 | $1,876.00 | not published | 0 |
| Lung function test (mbc/mvv) CPT 94200 | $182.91 | $469.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $415.35 | $1,065.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $650.52 | $1,668.00 | not published | 0 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $26,421.41 | $67,747.20 | not published | 0 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $2,737.80 | $7,020.00 | not published | 0 |
| Lvad shower bag heartmate HCPCS Q0501 | $542.77 | $1,391.73 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $920.79 | $2,361.00 | not published | 0 |
| Lymphocyte transformation mitogen CPT 86353 | $235.56 | $604.00 | not published | 0 |
| Lymph vessel x-ray arm/leg CPT 75801 | $687.96 | $1,764.00 | not published | 0 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,229.24 | $5,716.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75805 | $2,542.41 | $6,519.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $1,775.28 | $4,552.00 | not published | 0 |
| Lysis of labial adhesions CPT 56441 | $6,276.66 | $16,094.00 | not published | 0 |
| Lysis penil circumic lesion CPT 54162 | $4,673.37 | $11,983.00 | not published | 0 |
| Macroscopic exam arthropod CPT 87168 | $113.88 | $292.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $43.29 | $111.00 | not published | 0 |
| Magnesium CPT 83735 | $83.85 | $215.00 | not published | 0 |
| Magnetic image bone marrow CPT 77084 | $333.06 | $854.00 | not published | 0 |
| Mammosite ced HCPCS C1728 | $5,848.89 | $14,997.15 | not published | 0 |
| Manual diff wbc count b-coat CPT 85009 | $25.74 | $66.00 | not published | 0 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $567.06 | $1,454.00 | not published | 0 |
| Map tachycard site(s) CPT 93609 | $2,755.74 | $7,066.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $508.60 | $1,304.10 | not published | 0 |
| Mastoids complete CPT 70130 | $299.52 | $768.00 | not published | 0 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $2,045.29 | $5,244.34 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $263.64 | $676.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $218.01 | $559.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $175.50 | $450.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $121.56 | $311.70 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $93.60 | $240.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $196.56 | $504.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $139.62 | $358.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $547.95 | $1,405.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $427.44 | $1,096.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $225.42 | $578.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,909.44 | $4,896.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $239.07 | $613.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $190.32 | $488.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $235.95 | $605.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $179.01 | $459.00 | not published | 0 |
| Mayo avwpr vw factor activity CPT 85397 | $265.59 | $681.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $126.75 | $325.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $1,255.02 | $3,218.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $454.35 | $1,165.00 | not published | 0 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $64.74 | $166.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $85.80 | $220.00 | not published | 0 |
| Mayo brcmg brucella antibody igm CPT 86622 | $109.20 | $280.00 | not published | 0 |
| Mayo c1 esterase inhibitor CPT 83883 | $195.39 | $501.00 | not published | 0 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $409.50 | $1,050.00 | not published | 0 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $60.84 | $156.00 | not published | 0 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $390.39 | $1,001.00 | not published | 0 |
| Mayo ceruloplasmin CPT 82390 | $98.67 | $253.00 | not published | 0 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $171.21 | $439.00 | not published | 0 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $151.71 | $389.00 | not published | 0 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $104.91 | $269.00 | not published | 0 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $103.35 | $265.00 | not published | 0 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $601.38 | $1,542.00 | not published | 0 |
| Mayo chromium CPT 82495 | $131.82 | $338.00 | not published | 0 |
| Mayo coccidioides antibody CPT 86635 | $40.95 | $105.00 | not published | 0 |
| Mayo cocou cortisone urine CPT 82542 | $544.44 | $1,396.00 | not published | 0 |
| Mayo cortisol free CPT 82530 | $175.50 | $450.00 | not published | 0 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $186.42 | $478.00 | not published | 0 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $135.33 | $347.00 | not published | 0 |
| Mayo cyanide CPT 82600 | $184.47 | $473.00 | not published | 0 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $1,352.52 | $3,468.00 | not published | 0 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $116.61 | $299.00 | not published | 0 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $279.24 | $716.00 | not published | 0 |
| Mayo dihydrotestosterone CPT 82642 | $79.56 | $204.00 | not published | 0 |
| Mayo efpo chloride stool CPT 82438 | $52.26 | $134.00 | not published | 0 |
| Mayo estriol CPT 82677 | $188.76 | $484.00 | not published | 0 |
| Mayo estrone CPT 82679 | $221.91 | $569.00 | not published | 0 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $102.57 | $263.00 | not published | 0 |
| Mayo everolimus therapeutic drug level CPT 80169 | $154.83 | $397.00 | not published | 0 |
| Mayo factor ii CPT 85210 | $99.06 | $254.00 | not published | 0 |
| Mayo factor v CPT 85220 | $280.80 | $720.00 | not published | 0 |
| Mayo factor vii CPT 85230 | $216.45 | $555.00 | not published | 0 |
| Mayo factor viii vw factor antigen CPT 85246 | $271.83 | $697.00 | not published | 0 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $254.28 | $652.00 | not published | 0 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $283.53 | $727.00 | not published | 0 |
| Mayo factor x CPT 85260 | $216.45 | $555.00 | 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.