Sentara Martha Jefferson Hospital
500 Martha Jefferson Drive, Charlottesville, VA · Sentara · · NPI 1346248663
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 |
|---|---|---|---|---|
| Trnscath tx thromblytc vein ini day CPT 37212 | $5,016.00 | $10,032.00 | $2,004.00 – $8,246.00 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | not published | not published | $511.00 – $2,004.00 | 2 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $3,186.00 | $6,372.00 | $2,053.37 – $3,895.00 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | $3,186.00 | $6,372.00 | $2,053.37 – $3,895.00 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | $2,383.00 | $4,766.00 | $1,571.00 – $3,276.00 | 6 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $653.54 – $768.88 | 5 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $3,304.80 – $3,402.00 | 4 |
| Trnsxj/repos abrrnt rnl vsls CPT 50100 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Troponin quantitative CPT 84484 | $46.00 | $92.00 | $12.72 – $16.50 | 5 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $547.36 – $2,845.00 | 6 |
| Trurl dstrj prst8 tiss rf wv CPT 53854 | not published | not published | $2,670.00 – $5,978.00 | 5 |
| Tte w or without contr, cont ecg HCPCS C8930 | $1,064.00 | $2,128.00 | $780.16 – $803.10 | 4 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,482.50 | $2,965.00 | $780.16 – $803.10 | 4 |
| Tte w or without fol w/cont, com HCPCS C8921 | not published | not published | $780.16 – $803.10 | 4 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | not published | not published | $780.16 – $803.10 | 4 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Tubular dressing HCPCS A6457 | $28.46 | $56.93 | not published | 0 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $439.06 – $1,010.00 | 6 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $4,007.00 – $10,995.00 | 5 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $8,246.00 – $8,246.00 | 1 |
| Tx atrial fib pulm vein isol CPT 93656 | $11,948.00 | $23,896.00 | $5,980.00 – $26,713.67 | 4 |
| Tx closed distal humerus fx CPT 24999 | $390.00 | $780.00 | $245.48 – $511.00 | 5 |
| Tx closed hip disl traumatic without anes CPT 27250 | $197.00 | $394.00 | $245.48 – $1,010.00 | 6 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $1,625.00 | $3,250.00 | $1,010.00 – $3,344.08 | 6 |
| Tx closed tib shaft fx without manip CPT 27750 | $336.50 | $673.00 | $245.48 – $1,010.00 | 6 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $735.52 – $2,845.00 | 6 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $511.00 – $2,845.00 | 6 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Tx l/r atrial fib addl CPT 93657 | $4,204.00 | $8,408.00 | $2,004.00 – $2,004.00 | 1 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $3,552.50 | $7,105.00 | $3,256.29 – $5,978.00 | 6 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $3,131.00 | $6,262.00 | $3,256.29 – $5,978.00 | 6 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $3,299.54 – $5,978.00 | 6 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $3,886.00 | $7,772.00 | $3,256.29 – $5,978.00 | 6 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $1,547.00 – $2,670.00 | 2 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $106.50 | $213.00 | $245.48 – $2,845.00 | 6 |
| Tympanic membrane repair CPT 69610 | not published | not published | $1,544.13 – $5,978.00 | 5 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $1,010.00 – $10,995.00 | 6 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $214.89 – $221.21 | 4 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $765.00 | $1,530.00 | $511.00 – $1,010.00 | 6 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $5,418.00 – $10,995.00 | 6 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $5,418.00 – $10,995.00 | 6 |
| Tyms gene com variants CPT 81346 | not published | not published | $178.31 – $209.77 | 5 |
| U2af1 gene common variants CPT 81357 | not published | not published | $197.12 – $231.90 | 5 |
| Ua w/micro/comp poc CPT 81000 | $11.00 | $22.00 | $4.10 – $5.32 | 5 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $72.17 – $74.29 | 4 |
| Ugt1a1 gene analy common variants CPT 81350 | $855.50 | $1,711.00 | $238.68 – $280.80 | 5 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $302.50 | $605.00 | $104.04 – $107.10 | 4 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $104.04 – $107.10 | 4 |
| Ultrasound breast complete CPT 76641 | $387.00 | $774.00 | $104.04 – $107.10 | 4 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $351.50 | $703.00 | $86.61 – $89.15 | 4 |
| Ultrasound chest CPT 76604 | $488.00 | $976.00 | $104.04 – $107.10 | 4 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $411.00 | $822.00 | $104.04 – $107.10 | 4 |
| Ultrasound dx ophth b-scan CPT 76512 | $275.00 | $550.00 | $104.04 – $107.10 | 4 |
| Ultrasound elastography ea l target les CPT 76983 | $336.50 | $673.00 | not published | 0 |
| Ultrasound elastography parenchyma CPT 76981 | $336.50 | $673.00 | $104.04 – $107.10 | 4 |
| Ultrasound encephalogram CPT 76506 | $375.00 | $750.00 | $104.04 – $107.10 | 4 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $496.50 | $993.00 | $104.04 – $107.10 | 4 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $428.00 | $856.00 | $104.04 – $107.10 | 4 |
| Ultrasound guidance for vascular access CPT 76937 | $116.00 | $232.00 | not published | 0 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $404.00 | $808.00 | not published | 0 |
| Ultrasound guide intraoperative CPT 76998 | $475.50 | $951.00 | not published | 0 |
| Ultrasound guide tissue ablation CPT 76940 | $273.00 | $546.00 | not published | 0 |
| Ultrasound hips infant dynamic CPT 76885 | $492.00 | $984.00 | $86.61 – $89.15 | 4 |
| Ultrasound infant hips ltd without stress CPT 76886 | $171.00 | $342.00 | $86.61 – $89.15 | 4 |
| Ultrasound joint complete left CPT 76881 | $488.00 | $976.00 | $104.04 – $107.10 | 4 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $90.50 | $181.00 | $104.04 – $107.10 | 4 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | $404.00 | $808.00 | $104.04 – $107.10 | 4 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $785.50 | $1,571.00 | not published | 0 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $264.00 | $528.00 | not published | 0 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $551.00 | $1,102.00 | $237.46 – $244.44 | 4 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $218.50 | $437.00 | $104.04 – $107.10 | 4 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $428.00 | $856.00 | $104.04 – $107.10 | 4 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $428.00 | $856.00 | $104.04 – $107.10 | 4 |
| Ultrasound prostate/transrectal CPT 76872 | $392.00 | $784.00 | $104.04 – $107.10 | 4 |
| Ultrasound retroperitoneal limited CPT 76775 | $383.00 | $766.00 | $104.04 – $107.10 | 4 |
| Ultrasound scrotum and contents CPT 76870 | $495.00 | $990.00 | $104.04 – $107.10 | 4 |
| Ultrasound spinal canal and contents CPT 76800 | $375.00 | $750.00 | $104.04 – $107.10 | 4 |
| Ultrasound transabd ea addl gest CPT 76812 | $334.00 | $668.00 | not published | 0 |
| Ultrasound transvaginal non obstetric CPT 76830 | $423.50 | $847.00 | $104.04 – $107.10 | 4 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | $687.50 | $1,375.00 | $347.20 – $357.41 | 4 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | $436.00 | $872.00 | not published | 0 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.32 – $8.57 | 4 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $303.27 – $1,010.00 | 6 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $511.00 – $3,304.00 | 2 |
| Unlisted chemotherapy px CPT 96549 | $214.00 | $428.00 | $46.60 – $47.97 | 4 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $235.71 – $511.00 | 5 |
| Unlisted CT procedure CPT 76497 | not published | not published | $86.61 – $89.15 | 4 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $397.85 – $409.55 | 4 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $6.07 – $53.39 | 5 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $6.07 – $53.39 | 5 |
| Unlisted dialysis procedure CPT 90999 | $385.00 | $770.00 | not published | 0 |
| Unlisted dx gi procedure CPT 91299 | $283.50 | $567.00 | $128.06 – $511.00 | 5 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $397.85 – $409.55 | 4 |
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.