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 |
|---|---|---|---|---|
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | $1,112.50 | $2,225.00 | $702.49 – $2,845.00 | 6 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | $886.00 | $1,772.00 | $702.49 – $2,845.00 | 6 |
| Chemodenervation anal musc CPT 46505 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $262.50 | $525.00 | $305.48 – $1,010.00 | 6 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $315.88 – $1,010.00 | 6 |
| Chemodenerv eccrine glands CPT 64653 | not published | not published | $305.48 – $1,010.00 | 6 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $305.48 – $1,010.00 | 6 |
| Chemodenerv musc migraine 64615 CPT 64615 | $562.00 | $1,124.00 | $305.48 – $2,845.00 | 6 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $410.50 | $821.00 | $305.48 – $2,845.00 | 6 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | $471.00 | $942.00 | $305.48 – $2,845.00 | 6 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | $1,071.50 | $2,143.00 | $702.49 – $2,845.00 | 6 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | $1,457.00 | $2,914.00 | $702.49 – $2,845.00 | 6 |
| Chemo extend IV infus w/pump HCPCS G0498 | $820.50 | $1,641.00 | $328.72 – $338.39 | 4 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $46.60 – $47.97 | 4 |
| Chemo ia infusion up to 1 hr CPT 96422 | not published | not published | $328.72 – $338.39 | 4 |
| Chemo ia push tecnique CPT 96420 | $374.50 | $749.00 | $328.72 – $338.39 | 4 |
| Chemo intralesional over 7 CPT 96406 | not published | not published | $211.68 – $217.91 | 4 |
| Chemo intralesional up to 7 96405 CPT 96405 | not published | not published | $71.65 – $73.76 | 4 |
| Chemotaxis assay CPT 86155 | not published | not published | $16.31 – $26.80 | 5 |
| Chemotherapy injection 96542 CPT 96542 | not published | not published | $328.72 – $338.39 | 4 |
| Chemotx admn pertl cav impl CPT 96446 | not published | not published | $328.72 – $338.39 | 4 |
| Chest 2 vws w oblique CPT 71048 | $245.00 | $490.00 | $104.04 – $107.10 | 4 |
| Chest apical lordotic proj CPT 71047 | $198.50 | $397.00 | $86.61 – $89.15 | 4 |
| Chest CT scan (with and without contrast) CPT 71270 | $1,485.00 | $2,970.00 | $174.56 – $179.69 | 4 |
| Chest CT scan (with contrast) CPT 71260 | $1,240.50 | $2,481.00 | $174.56 – $179.69 | 4 |
| Chest CT scan (without contrast) CPT 71250 | $982.50 | $1,965.00 | $104.04 – $107.10 | 4 |
| Chest X-ray CPT 71046 | $154.00 | $308.00 | $86.61 – $89.15 | 4 |
| Chest X-ray (single view) CPT 71045 | $126.50 | $253.00 | $86.61 – $89.15 | 4 |
| Chg pr pul rehab for copd patients CPT 94626 | $129.50 | $259.00 | $58.71 – $60.44 | 4 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $479.00 | $958.00 | $174.56 – $179.69 | 4 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $211.61 – $339.64 | 5 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $266.01 – $426.94 | 5 |
| Chiropractic manj 5 regions CPT 98942 | $123.50 | $247.00 | not published | 0 |
| Chiropract manj 1-2 regions CPT 98940 | $60.00 | $120.00 | not published | 0 |
| Chiropract manj 3-4 regions CPT 98941 | $72.50 | $145.00 | not published | 0 |
| Chlamydia culture CPT 87110 | $68.00 | $136.00 | $19.99 – $32.84 | 5 |
| Chlamydia trachomatis ag if CPT 87270 | $61.50 | $123.00 | $12.22 – $20.11 | 5 |
| Chlamydia type CPT 87140 | $27.50 | $55.00 | $5.68 – $9.35 | 5 |
| Chlmyd pneum dna dir probe CPT 87485 | not published | not published | $20.45 – $33.62 | 5 |
| Chlmyd pneum dna quant CPT 87487 | not published | not published | $43.70 – $71.82 | 5 |
| Chlnggrphy intraop addl s&i CPT 74301 | $91.50 | $183.00 | not published | 0 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $51.27 – $52.77 | 4 |
| Chlordiazepoxide injection HCPCS J1990 | not published | not published | $59.25 – $59.25 | 1 |
| Chloride CPT 82435 | $22.00 | $44.00 | $4.69 – $7.70 | 5 |
| Chloride 24 hour urine CPT 82436 | $24.00 | $48.00 | $5.86 – $8.42 | 5 |
| Chloroprocaine (clorotekal) HCPCS J2402 | not published | not published | $0.82 – $0.82 | 1 |
| Chloroprocaine hcl injection HCPCS J2401 | not published | not published | $0.08 – $0.08 | 1 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $0.59 – $0.61 | 4 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | not published | not published | $168.25 – $168.25 | 1 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | not published | not published | $84.80 – $84.80 | 1 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $328.72 – $338.39 | 4 |
| Cholangiogram percutaneous compl CPT 47532 | $4,865.00 | $9,730.00 | $2,670.00 – $8,246.00 | 6 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $475.00 | $950.00 | not published | 0 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $1,547.00 – $4,339.00 | 2 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $1,547.00 – $4,007.00 | 2 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $3,884.50 | $7,769.00 | $3,563.21 – $8,246.00 | 5 |
| Cholesterol CPT 82465 | $21.00 | $42.00 | $4.44 – $7.30 | 5 |
| Cholesterol body fluid CPT 84999 | $120.18 | $240.35 | $6.07 – $6.07 | 1 |
| Cholesterol (Lipid) Test CPT 80061 | $73.50 | $147.00 | $13.66 – $22.46 | 5 |
| Choline c-11 HCPCS A9515 | not published | not published | $2,566.76 – $2,642.25 | 4 |
| Cholinesterase CPT 82480 | $36.00 | $72.00 | $8.03 – $13.21 | 5 |
| Cholinesterase challenge CPT 95857 | not published | not published | $214.89 – $221.21 | 4 |
| Chorion biopsy CPT 59015 | not published | not published | $916.63 – $2,845.00 | 6 |
| Chorionic gonadotropin/1000u HCPCS J0725 | not published | not published | $54.75 – $54.75 | 1 |
| Chrom analysis CPT 88273 | $188.00 | $376.00 | $35.51 – $53.87 | 5 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $32.87 – $40.95 | 5 |
| Chromatography CPT 83021 | $80.00 | $160.00 | $18.42 – $30.28 | 5 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $12.13 – $19.94 | 5 |
| Chromo high res and frag x - sendout CPT 81243 | $295.00 | $590.00 | $58.18 – $68.45 | 5 |
| Chromosome analys amniotic CPT 88269 | $959.50 | $1,919.00 | $177.13 – $278.86 | 5 |
| Chromosome analysis 100 CPT 88249 | $184.00 | $368.00 | $176.63 – $290.35 | 5 |
| Chromosome analysis 15-20 cell count CPT 88262 | $686.50 | $1,373.00 | $128.00 – $208.97 | 5 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $176.63 – $249.58 | 5 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $153.30 – $251.96 | 5 |
| Chromosome analysis 5 CPT 88261 | $1,019.00 | $2,038.00 | $269.63 – $296.32 | 5 |
| Chromosome analysis 50-100 CPT 88248 | $179.50 | $359.00 | $176.63 – $290.35 | 5 |
| Chromosome analys placenta CPT 88267 | $132.50 | $265.00 | $192.34 – $301.40 | 5 |
| Chromosome banding study CPT 88283 | not published | not published | $69.97 – $115.01 | 5 |
| Chromosome count additional CPT 88285 | $111.00 | $222.00 | $27.45 – $31.85 | 5 |
| Chromosome karyotype study CPT 88280 | $141.00 | $282.00 | $34.14 – $42.08 | 5 |
| Chromosome study additional CPT 88289 | $199.50 | $399.00 | $35.12 – $57.73 | 5 |
| Chronic urticaria - sendout CPT 86343 | $53.00 | $106.00 | $12.71 – $20.89 | 5 |
| Chylomicron screen, bf - sendout CPT 82664 | $21.00 | $42.00 | $57.60 – $64.58 | 5 |
| Cidofovir injection HCPCS J0740 | not published | not published | $557.22 – $573.61 | 4 |
| Cilastatin sodium injection HCPCS J0743 | not published | not published | $12.03 – $20.03 | 2 |
| Ciliary transsleral therapy CPT 66710 | $1,108.00 | $2,216.00 | $1,571.00 – $5,978.00 | 6 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $0.02 – $594,162.39 | 4 |
| Cinacalcet 30 mg tablet HCPCS J0604 | not published | not published | $0.05 – $0.05 | 1 |
| Cine/video x-rays CPT 76120 | not published | not published | $104.04 – $107.10 | 4 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | not published | not published | $2.31 – $2.31 | 1 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $76.53 – $76.53 | 1 |
| Circum 28 days or older CPT 54161 | $1,495.50 | $2,991.00 | $1,571.00 – $5,978.00 | 6 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $1,270.50 | $2,541.00 | $693.95 – $5,978.00 | 6 |
| Circumcision (newborn) CPT 54150 | $1,623.50 | $3,247.00 | $1,010.00 – $5,978.00 | 6 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | not published | not published | $7.47 – $7.47 | 1 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $601.00 | $1,202.00 | $336.10 – $395.41 | 5 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | not published | not published | $10.89 – $11.21 | 4 |
| C-laminoplasty w/graft/plate CPT 63051 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $5,029.06 | $10,058.13 | 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.