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 |
|---|---|---|---|---|
| Blood mucoprotein HCPCS P2038 | not published | not published | $5.05 – $8.42 | 5 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $22.00 | $44.00 | $16.24 – $26.66 | 5 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $19.00 | $38.00 | $4.31 – $5.45 | 5 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $21.00 | $42.00 | $4.47 – $5.45 | 5 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $22.00 | $44.00 | $5.43 – $5.59 | 5 |
| Blood smear interpretation CPT 85060 | not published | not published | $14.14 – $62.00 | 2 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $0.50 | $1.00 | $3.88 – $5.77 | 5 |
| Blood split unit HCPCS P9011 | $261.50 | $523.00 | not published | 0 |
| Blood thymol turbidity HCPCS P2033 | not published | not published | $5.05 – $7.33 | 5 |
| Blood typing abo CPT 86900 | $65.00 | $130.00 | $5.00 – $133.71 | 5 |
| Blood typing ag donor ea ag CPT 86902 | $182.00 | $364.00 | $6.46 – $360.22 | 5 |
| Blood typing antigen system CPT 86911 | not published | not published | $17.74 – $56.29 | 2 |
| Blood typing paternity test CPT 86910 | not published | not published | $23.20 – $65.09 | 2 |
| Blood typing patient serum CPT 86904 | $43.00 | $86.00 | $15.94 – $59.28 | 5 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $182.00 | $364.00 | $6.41 – $360.22 | 5 |
| Blood typing rh (d) CPT 86901 | $76.00 | $152.00 | $5.65 – $37.54 | 5 |
| Blood typing rh phenotype complete reference CPT 86906 | $43.50 | $87.00 | $13.00 – $37.54 | 5 |
| Blood volume CPT 78122 | not published | not published | $540.36 – $556.26 | 4 |
| Blue light cysto imag agent HCPCS C9738 | not published | not published | $511.00 – $2,004.00 | 2 |
| Bone biopsy open superficial CPT 20240 | $2,341.50 | $4,683.00 | $1,571.00 – $5,978.00 | 6 |
| Bone Density Scan (DEXA) CPT 77080 | $392.00 | $784.00 | $104.04 – $107.10 | 4 |
| Bone imaging multiple areas CPT 78305 | $837.50 | $1,675.00 | $397.85 – $409.55 | 4 |
| Bone/joint imaging ltd area CPT 78300 | $836.50 | $1,673.00 | $397.85 – $409.55 | 4 |
| Bone marrow;aspiration only 38220 CPT 38220 | $1,166.00 | $2,332.00 | $1,010.00 – $1,692.01 | 6 |
| Bone marrow aspir bone grfg CPT 20939 | not published | not published | $511.00 – $2,004.00 | 2 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $1,165.50 | $2,331.00 | $1,010.00 – $1,692.01 | 6 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $1,549.95 – $3,276.00 | 5 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Bone marrow imaging body CPT 78104 | $909.50 | $1,819.00 | $397.85 – $409.55 | 4 |
| Bone marrow imaging ltd CPT 78102 | $837.50 | $1,675.00 | $397.85 – $409.55 | 4 |
| Bone marrow imaging mult CPT 78103 | $837.50 | $1,675.00 | $397.85 – $409.55 | 4 |
| Bone marrow interpretation CPT 85097 | not published | not published | $29.60 – $823.43 | 5 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $3,338.00 – $13,397.00 | 6 |
| Bone/skin graft iliac crest CPT 20970 | not published | not published | $3,338.00 – $10,995.00 | 5 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $3,338.00 – $13,397.00 | 6 |
| Bone/skin graft microvasc CPT 20969 | not published | not published | $3,338.00 – $10,995.00 | 5 |
| Bone survey-lead poisoning CPT 77074 | $355.00 | $710.00 | $104.04 – $107.10 | 4 |
| Boot heel care softcare one sz HCPCS E0191 | $11.90 | $23.81 | not published | 0 |
| Boot j walker l HCPCS L4386 | $123.68 | $247.37 | not published | 0 |
| Boot mlti podous univ xlg HCPCS L4396 | $125.76 | $251.51 | not published | 0 |
| Boot softgait shrt m HCPCS L4387 | $120.58 | $241.16 | not published | 0 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $411.93 | $823.86 | not published | 0 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | $173.88 | $347.76 | not published | 0 |
| Borrelia antibody CPT 86619 | not published | not published | $13.65 – $22.43 | 5 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $149.50 | $299.00 | $17.37 – $28.56 | 5 |
| Borrelia miyamotoi amp prb CPT 87478 | not published | not published | $35.79 – $42.11 | 5 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | not published | not published | $6.17 – $6.17 | 1 |
| (both sides) smear without diff wbc count CPT 85008 | not published | not published | $3.50 – $5.77 | 5 |
| Bowel imaging CPT 78290 | $778.50 | $1,557.00 | $397.85 – $409.55 | 4 |
| Bpg axillary-pop/-tibial CPT 35623 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg carotid-vertebral CPT 35642 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg ilio-celiac CPT 35632 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg ilio-mesenteric CPT 35633 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg iliorenal CPT 35634 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg pop-tibl/-prnl artery CPT 35671 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg splenorenal CPT 35636 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg subclavian-axillary CPT 35616 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Bpg subclavian-vertebral CPT 35645 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Brace adj motion lerman type HCPCS L2186 | $145.94 | $291.87 | not published | 0 |
| Brace afo lg left 6607 HCPCS L1930 | $146.46 | $292.91 | not published | 0 |
| Brace afopos solid ankle cust HCPCS L1960 | $449.19 | $898.38 | not published | 0 |
| Brace afo spiral prefab HCPCS L1951 | $704.32 | $1,408.64 | not published | 0 |
| Brace ank aftr bioskn med lg HCPCS L1906 | $128.34 | $256.68 | not published | 0 |
| Brace ank air stirrup univ HCPCS L4350 | $50.72 | $101.43 | not published | 0 |
| Brace ankle joint dflxn assist HCPCS L2210 | $55.38 | $110.75 | not published | 0 |
| Brace ankle stablizing lg HCPCS L1902 | $125.76 | $251.51 | not published | 0 |
| Brace back epic tslo 456 HCPCS L0457 | $618.42 | $1,236.83 | not published | 0 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | $227.18 | $454.37 | not published | 0 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $820.24 | $1,640.48 | not published | 0 |
| Brace back t-lso custom HCPCS L0486 | $1,427.78 | $2,855.57 | not published | 0 |
| Brace cust back lso HCPCS L0631 | $566.66 | $1,133.33 | not published | 0 |
| Brace fx hum ovr shldr sm HCPCS L3980 | $193.03 | $386.06 | not published | 0 |
| Brace halo bremer l2830 HCPCS L2830 | $74.00 | $148.01 | not published | 0 |
| Brace knee extender plus 22-30in HCPCS L1832 | $943.40 | $1,886.81 | not published | 0 |
| Brace knee hing pat open med HCPCS L1820 | $125.76 | $251.51 | not published | 0 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | $828.52 | $1,657.04 | not published | 0 |
| Brace knee postop tscope xl HCPCS L1845 | $569.25 | $1,138.50 | not published | 0 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | $101.43 | $202.86 | not published | 0 |
| Brace m arm board HCPCS L3809 | $117.00 | $234.00 | not published | 0 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $593.06 | $1,186.11 | not published | 0 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $549.07 | $1,098.14 | not published | 0 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $170.78 | $341.55 | not published | 0 |
| Brace wrist classic lft sm HCPCS L3908 | $54.00 | $108.00 | not published | 0 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $2,890.77 – $3,895.00 | 6 |
| Brach/thor cath 1st CPT 36215 | $2,196.50 | $4,393.00 | $511.00 – $2,670.00 | 2 |
| Brach/thor cath 2nd CPT 36216 | $2,230.00 | $4,460.00 | $511.00 – $2,670.00 | 2 |
| Brach/thor cath 3rd CPT 36217 | $1,568.50 | $3,137.00 | $511.00 – $2,670.00 | 2 |
| Brach/thor cath addl CPT 36218 | $1,193.00 | $2,386.00 | $511.00 – $2,670.00 | 2 |
| Brachy source i-125 injection HCPCS C2638 | $45.02 | $90.05 | not published | 0 |
| Brachy source iodine-125 nonstranded HCPCS C2639 | $31.57 | $63.14 | not published | 0 |
| Brachy source palladium HCPCS C2640 | $64.69 | $129.38 | not published | 0 |
| Brachy source palladium-103 nonstranded HCPCS C2641 | $50.72 | $101.43 | not published | 0 |
| Brachy source yttrium-90 HCPCS C2616 | $8,757.66 | $17,515.31 | not published | 0 |
| Brachy src nonstrand c-131 HCPCS C2643 | $63.14 | $126.27 | not published | 0 |
| Brachy src nonstrand hdr ir-192 HCPCS C1717 | $351.38 | $702.77 | not published | 0 |
| Brachy src stranded c-131 HCPCS C2642 | $96.26 | $192.51 | not published | 0 |
| Brachytx isodose complex CPT 77318 | $1,107.00 | $2,214.00 | $372.63 – $383.59 | 4 |
| Brachytx isodose intermed CPT 77317 | $856.00 | $1,712.00 | $372.63 – $383.59 | 4 |
| Brachytx isodose plan simple CPT 77316 | $708.50 | $1,417.00 | $372.63 – $383.59 | 4 |
| Brachytx, non-str, gold-198 HCPCS C1716 | $114.88 | $229.77 | 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.