Wellstar Sylvan Grove Hospital — price list
← Hospital overviewVerified from Wellstar Sylvan Grove Hospital’s published price file
Includes cash prices, list prices. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Acamprosate 333 mg tablet,delayed release Inpatient & outpatient | 1342688321 CDM | $62.50 | $24.38 | — | — | |
| Acetaminophen 1,000 mg/100 ml (10 mg/ml) intravenous solution Inpatient & outpatient | 1264433017 CDM | $103 | $39.98 | — | — | |
| Acetaminophen 1,000 mg/100 ml (10 mg/ml) intravenous solution Inpatient & outpatient | 1334201042 CDM | $379 | $148 | — | — | |
| Acetaminophen 10 mg/ml IV syringe (peds) Inpatient & outpatient | 1341814924 CDM | $19.60 | $7.64 | — | — | |
| Acetaminophen 120 mg rectal suppository Inpatient & outpatient | 1131914311 CDM | $1.70 | $0.66 | — | — | |
| Acetaminophen 120 mg rectal suppository Inpatient & outpatient | 1341626857 CDM | $0.70 | $0.27 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1294185691 CDM | $3.90 | $1.52 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1300130270 CDM | $4.10 | $1.60 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1317274655 CDM | $9.50 | $3.70 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1320297764 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1323877254 CDM | $12.10 | $4.72 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1331310766 CDM | $21.20 | $8.27 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1344605653 CDM | $18.10 | $7.06 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1346513768 CDM | $5.20 | $2.03 | — | — | |
| Acetaminophen 160 mg/5 ml oral liquid (wrapped) Inpatient & outpatient | 1350929131 CDM | $10.60 | $4.13 | — | — | |
| Acetaminophen 300 mg-codeine 30 mg tablet Inpatient & outpatient | 1329167844 CDM | $11.00 | $4.29 | — | — | |
| Acetaminophen 325 mg tablet Inpatient & outpatient | 1078116969 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 325 mg tablet Inpatient & outpatient | 1122810024 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 325 mg tablet Inpatient & outpatient | 1337366012 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 325 mg tablet Inpatient & outpatient | 1341797486 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 325 mg tablet Inpatient & outpatient | 1346180310 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 325 mg tablet Inpatient & outpatient | 1349699708 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 500 mg tablet Inpatient & outpatient | 1339128113 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 500 mg tablet Inpatient & outpatient | 1343245486 CDM | $0.60 | $0.23 | — | — | |
| Acetaminophen 500 mg tablet Inpatient & outpatient | 1346243845 CDM | $0.60 | $0.23 | — | — | |
| Acetazolamide 250 mg tablet Inpatient & outpatient | 1103084022 CDM | $16.10 | $6.28 | — | — | |
| Acetazolamide 250 mg tablet Inpatient & outpatient | 1343521228 CDM | $42.50 | $16.58 | — | — | |
| Acetazolamide 500 mg solution for injection Inpatient & outpatient | 1346226223 CDM | $269 | $105 | — | — | |
| Acetic acid 0.25 % irrigation solution Inpatient & outpatient | 1350400350 CDM | $52.60 | $20.51 | — | — | |
| Acetylcysteine 100 mg/ml (10 %) solution Inpatient & outpatient | 1351369889 CDM | $83.40 | $32.53 | — | — |