How many shoppable procedure prices are published for Wellstar Sylvan Grove Medical Center?

Wellstar Sylvan Grove Medical Center in Jackson, GA currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Wellstar Sylvan Grove Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Wellstar Sylvan Grove Medical Center's median negotiated commercial rate is 1.9× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · urban Updated: 2026-04-01

Wellstar Sylvan Grove Medical Center

1050 McDonough Road, Jackson, GA 30233 · 117 Priced Procedures · 76% Patient Recommendation

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

1.87×vs. Fair Market Price

Typical commercial prices here are +87% above the fair benchmark (1.87×) even after accounting for local nurse/doctor wages and patient complexity.

66/100 · Caution

66/100Self-Pay Cash Beats Insurance 30% of the Time

File Completeness66

Price Logic48

Peer Alignment59

Clean Billing65

Real Cash Discount100

High-Markup · Check Safety

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Wellstar Sylvan Grove Medical Center prices routine shoppable procedures near 2.3× Medicare (p50 1.92×) while skewing captive emergency, lab, and upper-quartile codes to 2.9× Medicare (p75 2.88×, +50% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#93 of 100 in GA · 92nd State Percentile#2,996 of 3,385 in U.S. · 88th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.43× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 30% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (71/100 safety score) with 76% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.87× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.5×) & laboratory (4.3×) services average 1.26× higher multiples than routine shoppable care (2.3×)
Upper-quartile procedures (Q75 2.88×) jump +50% above the median procedure ratio (Q50 1.92×)
Unnegotiated chargemaster list prices average 16.1× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.3× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.26× Divergence

2.9× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+50% Upper Tail

Q25 1.43× · Q50 1.92× · Q75 2.88×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.3× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.2× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

1.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

4.3× MedicareElevated

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.9× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

30% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 71/100Fair

Procedure Prices at Wellstar Sylvan Grove Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$58,138	$19,432	unverified
Total hip replacement CPT Code: `27130`	—	$26,930	$13,413	unverified
Total knee replacement CPT Code: `27447`	—	$26,930	$13,523	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$24,060	$8,223	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$15,026	$6,109	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$7,419	$3,372	2.2×
Inguinal hernia repair CPT Code: `49505`	—	$7,419	$3,629	2.0×
Bunion correction surgery CPT Code: `28296`	—	$7,129	$3,446	2.1×
Cataract surgery with lens implant CPT Code: `66984`	—	$6,669	$2,540	2.6×
Breast lump removal CPT Code: `19120`	—	$5,994	$3,875	1.5×
Vaginal delivery (full package) CPT Code: `59400`	—	$5,063	$2,680	1.9×
C-section delivery (full package) CPT Code: `59510`	—	$5,063	$2,975	1.7×
Trauma team activation HCPCS Code: `G0390`	$4,152	$4,152	$1,453	2.9×
Colonoscopy with biopsy CPT Code: `45380`	—	$3,829	$1,256	3.0×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$3,353	$981	3.4×
Upper endoscopy with biopsy CPT Code: `43239`	$1,406	$3,339	$987	3.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,068	$3,068	$1,021	3.0×
Blood transfusion CPT Code: `36430`	$1,278	$2,572	$498	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$1,895	$2,523	$855	3.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,835	$1,835	$583	3.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,393	$1,079	$511	2.1×
Neurobehavioral status check CPT Code: `96116`	$556	$1,004	$231	unverified
Rabies immune globulin HCPCS Code: `90375`	—	$928	$322	2.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$759	$759	$181	4.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$541	$692	$272	2.5×
MRI, lower back (no contrast) CPT Code: `72148`	$1,776	$692	$338	2.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$284	$682	$201	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$536	$536	$185	2.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$389	$510	$166	3.1×
Family therapy session CPT Code: `90847`	$205	$510	$173	2.9×
MRI, knee or other leg joint CPT Code: `73721`	$203	$508	$369	1.4×
Psychological testing evaluation CPT Code: `96136`	$286	$409	$128	3.2×
Group therapy session CPT Code: `90853`	$367	$367	$100	3.7×
Psychological testing by technician CPT Code: `96138`	$372	$372	$395	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$556	$329	$132	2.5×
CT scan, head (with contrast) CPT Code: `70460`	$1,588	$346	$242	1.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,881	$336	$258	1.3×
CT scan, sinuses CPT Code: `70486`	$1,319	$310	$166	1.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,611	$310	$168	1.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,224	$311	$303	1.0×
CT scan, head (no contrast) CPT Code: `70450`	$1,419	$265	$160	1.7×
CT scan, pelvis CPT Code: `72192`	$1,310	$260	$163	1.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$213	$213	$14	15.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$306	$196	$64	3.1×
Speech therapy (language evaluation) CPT Code: `92507`	$173	$173	$86	2.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$732	$197	$134	1.5×
Screening mammogram (both breasts) CPT Code: `77067`	$332	$179	$123	1.5×
Ultrasound, pelvis CPT Code: `76856`	$98	$180	$130	1.4×
MRI, brain (no contrast) CPT Code: `70551`	$203	$203	$343	0.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$205	$205	$448	0.5×
Office visit, established patient (30-39 min) CPT Code: `99214`	$168	$168	$123	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$547	$152	$126	1.2×
Speech therapy (group session) CPT Code: `92508`	$109	$109	$27	4.0×
Physical therapy (manual therapy) CPT Code: `97140`	$98	$98	$34	2.9×
X-ray, hip CPT Code: `73502`	$189	$121	$93	1.3×
Physical therapy (gait training) CPT Code: `97116`	$83	$83	$33	2.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$88	$88	$35	2.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$88	$88	$38	2.3×
Prosthetic fitting and training CPT Code: `97761`	$99	$99	$45	2.2×
Occupational therapy (self-care training) CPT Code: `97535`	$83	$83	$38	2.2×
X-ray, ankle CPT Code: `73610`	$261	$106	$93	1.1×
X-ray, hand CPT Code: `73130`	$264	$102	$93	1.1×
X-ray, pelvis CPT Code: `72170`	$243	$84	$110	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$107	$107	$167	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$107	$107	$169	0.6×
Pneumococcal vaccine HCPCS Code: `90732`	—	$408	$140	2.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$391	$203	1.9×
Blood test, vitamin D CPT Code: `82306`	$303	$303	$31	9.8×
Blood test, vitamin B12 CPT Code: `82607`	$262	$262	$16	16.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$212	$212	$14	15.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$206	$206	$19	10.8×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$197	$111	1.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$167	$167	$14	11.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$171	$171	$18	9.5×
Blood test, lipase CPT Code: `83690`	$143	$143	$7	20.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$138	$138	$11	12.5×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$122	$122	$10	12.2×
Hepatitis C antibody test CPT Code: `86803`	$140	$140	$15	9.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$163	$163	$20	8.2×
Blood test, liver function panel CPT Code: `80076`	$104	$104	$9	11.6×
Drug screening test HCPCS Code: `G0480`	$119	$119	$116	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$60	$60	$4	15.0×
Blood test, potassium CPT Code: `84132`	$75	$75	$5	15.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$59	$59	$4	14.8×
Blood test, sodium CPT Code: `84295`	$68	$68	$5	13.6×
Blood test, calcium CPT Code: `82310`	$62	$62	$5	12.4×
Blood test, magnesium CPT Code: `83735`	$84	$84	$7	12.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$85	$85	$8	10.6×
Hepatitis B vaccine HCPCS Code: `90744`	—	$92	$37	2.5×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$78	$78	$40	1.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$101	$56	1.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$66	$74	$35	2.1×
X-ray, chest (two views) CPT Code: `71046`	$294	$79	$93	0.8×
X-ray, lower back CPT Code: `72110`	$506	$76	$112	0.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$38	$38	$5	7.6×
Blood test, basic metabolic panel CPT Code: `80048`	$44	$44	$9	4.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$61	$39	1.6×
X-ray, foot CPT Code: `73630`	$261	$48	$92	0.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$70	$70	$148	0.5×
Blood test, hemoglobin CPT Code: `85018`	$21	$21	$3	7.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$25	$25	$5	5.0×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$42	$25	1.7×
Physical therapy (functional capacity test) CPT Code: `97750`	$50	$50	$38	1.3×
Flu vaccine injection HCPCS Code: `G0008`	$63	$63	$48	1.3×
Pneumonia vaccine injection HCPCS Code: `G0009`	$63	$63	$49	1.3×
Colorectal cancer screening HCPCS Code: `G0010`	$63	$63	$49	1.3×
Orthotic fitting and training CPT Code: `97760`	$60	$60	$51	1.2×
X-ray, chest (single view) CPT Code: `71045`	$253	$43	$92	0.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$9	$9	$3	3.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$12	$12	$6	2.0×
Culture, bacterial CPT Code: `87070`	$18	$18	$9	2.0×
Culture, blood CPT Code: `87040`	$21	$21	$11	1.9×
Blood test, amylase CPT Code: `82150`	$13	$13	$7	1.9×
Blood antibody screen CPT Code: `86850`	$247	$20	$46	0.4×
X-ray, shoulder CPT Code: `73030`	$25	$25	$92	0.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$25	$25	$93	0.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$2	$2	$86	0.0×

Showing top 25 high-impact procedures of 117 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Wellstar Sylvan Grove Medical Center (Zero PHI Required)

CMS CCN: 111319

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash Request Quote

Insurer Median $58,138

1. Amount on Your Bill or Quote ($) Pre-filled with Wellstar Sylvan Grove Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Wellstar Sylvan Grove Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$120,099 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($139,531) is $120,099 above the denoised Fair BaseRate ($19,432) and 9.9× the $14,044 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Wellstar Sylvan Grove Medical Center as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite71/100

Would Recommend76%

Rated 9 or 10 (HCAHPS)79%

Median ER Wait110 min

Left ER Before Seen1%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (76 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Wellstar Sylvan Grove Medical Center.

Price Index: 0.98× regional baseline

Quality: 57/100 CMS composite

Median Household Income$59,221U.S. Census ACS

Local Uninsured Share11.9%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 66/100 · Caution CMS CCN 111319

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 111319) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows270 (CMS v3.0.0)

File Integrity DigestVerified · CCN 111319

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy