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 |
|---|---|---|---|---|
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $406.50 | $813.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $271.50 | $543.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $2,781.00 | $5,562.00 | $1,571.00 – $3,388.50 | 6 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $1,571.00 – $1,571.00 | 1 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $783.50 | $1,567.00 | $1,571.00 – $3,276.00 | 6 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $440.50 | $881.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $106.50 | $213.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx pelvic ring fx CPT 27197 | $185.00 | $370.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $245.48 – $1,010.00 | 6 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $741.00 | $1,482.00 | $1,010.00 – $1,647.34 | 6 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $262.50 | $525.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $106.50 | $213.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $783.50 | $1,567.00 | $511.00 – $1,647.34 | 6 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $106.50 | $213.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $741.00 | $1,482.00 | $1,547.00 – $1,647.34 | 6 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $741.00 | $1,482.00 | $511.00 – $1,647.34 | 6 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,434.50 | $2,869.00 | $1,010.00 – $3,276.00 | 6 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $1,010.00 – $3,344.08 | 6 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $351.00 | $702.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $332.50 | $665.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $245.50 | $491.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,166.50 | $2,333.00 | $1,010.00 – $1,647.34 | 6 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $106.50 | $213.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $510.00 | $1,020.00 | $245.48 – $1,010.00 | 6 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $106.50 | $213.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $336.50 | $673.00 | $245.48 – $2,845.00 | 6 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | not published | not published | $245.48 – $1,571.00 | 6 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $336.50 | $673.00 | $245.48 – $2,845.00 | 6 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $185.00 | $370.00 | $245.48 – $1,010.00 | 6 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $529.00 | $1,058.00 | $245.48 – $1,571.00 | 6 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $1,264.00 | $2,528.00 | $1,547.00 – $1,647.34 | 6 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $3,338.00 – $10,995.00 | 5 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $1,294.00 | $2,588.00 | $1,571.00 – $3,276.00 | 6 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $241.00 | $482.00 | $245.48 – $1,010.00 | 6 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $2,349.50 | $4,699.00 | $511.00 – $1,647.34 | 6 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $374.50 | $749.00 | $245.48 – $1,010.00 | 6 |
| Cltx lunate dislc w/mnpj CPT 25690 | $741.00 | $1,482.00 | $1,010.00 – $3,276.00 | 6 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $5,007.00 | $10,014.00 | $3,304.00 – $10,995.00 | 6 |
| Cltx mndblr fx w/mnpj CPT 21451 | not published | not published | $1,544.13 – $4,314.00 | 6 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $2,056.00 | $4,112.00 | $3,299.54 – $5,978.00 | 6 |
| Cltx palatal/max fx wire fix CPT 21421 | not published | not published | $3,299.54 – $5,978.00 | 6 |
| Cltx post ankle fx CPT 27767 | not published | not published | $245.48 – $1,010.00 | 6 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,397.00 | $4,794.00 | $511.00 – $1,647.34 | 6 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,278.50 | $2,557.00 | $511.00 – $1,647.34 | 6 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $729.50 | $1,459.00 | $245.48 – $1,010.00 | 6 |
| Cltx thigh fx CPT 27267 | $4,760.00 | $9,520.00 | $1,010.00 – $3,344.08 | 6 |
| Cltx thigh fx w/mnpj CPT 27268 | not published | not published | $1,600.27 – $8,246.00 | 5 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $1,544.13 – $3,276.00 | 6 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $4,007.00 – $8,246.00 | 6 |
| C motor evoked lwr limbs CPT 95929 | $650.00 | $1,300.00 | $371.37 – $382.29 | 4 |
| C motor evoked uppr limbs CPT 95928 | $650.00 | $1,300.00 | $854.62 – $879.75 | 4 |
| C motor evoked upr&lwr limbs CPT 95939 | $1,081.00 | $2,162.00 | $854.62 – $879.75 | 4 |
| Cmp rpr tof wo plm atrs ptch CPT 33694 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $58.71 – $60.44 | 4 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $58.71 – $60.44 | 4 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $10.04 – $14.77 | 5 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $8.98 – $13.87 | 5 |
| #cmvcul-virus inoculation shell CPT 87254 | $127.00 | $254.00 | $19.95 – $32.78 | 5 |
| Cmv pcr-sendout CPT 87496 | $79.50 | $159.00 | $35.79 – $58.85 | 5 |
| Cnbp gene detc abnor allele CPT 81187 | not published | not published | $139.74 – $164.40 | 5 |
| Cntct lens hydrophil photoch HCPCS V2524 | not published | not published | $190.00 – $195.58 | 4 |
| Co2 monitor per day CPT 94681 | $294.00 | $588.00 | $371.37 – $382.29 | 4 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | not published | not published | $2.71 – $2.79 | 4 |
| Coagulation time activated teg CPT 85347 | $23.50 | $47.00 | $4.37 – $7.14 | 5 |
| Coagulation time lee & white CPT 85345 | not published | not published | $4.78 – $7.21 | 5 |
| Coagulation time otr method CPT 85348 | not published | not published | $4.58 – $6.24 | 5 |
| Coccidioidomycosis skin test CPT 86490 | not published | not published | $7.74 – $7.74 | 1 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $128.06 – $131.82 | 4 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $128.06 – $131.82 | 4 |
| Codeine 15 mg/ml inj 2 ml HCPCS J0745 | not published | not published | $3.42 – $3.42 | 1 |
| Coil axium 3d 14mmx40cm qc HCPCS C1770 | $294.98 | $589.95 | not published | 0 |
| Cold agglutinin screen (arc) CPT 86156 | $31.00 | $62.00 | $8.23 – $11.23 | 5 |
| Cold agglutinin titer CPT 86157 | $35.50 | $71.00 | $8.22 – $13.52 | 5 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy prtl w/coloproctostomy 44145 CPT 44145 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy prtl w/coloproctostomy + colostomy 44146 CPT 44146 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy prtl w/skin level cecost/colostomy 44141 CPT 44141 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy/w colostomy or ileostomy 44144 CPT 44144 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy w/ileoanal anast CPT 44157 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colectomy w/neo-rectum pouch CPT 44158 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Colistimethate sodium inj HCPCS J0770 | not published | not published | $33.84 – $33.84 | 1 |
| Collagenase, clost hist inj HCPCS J0775 | not published | not published | $77.42 – $79.70 | 4 |
| Collagen dressing <=16 sq in HCPCS A6021 | $23.29 | $46.58 | not published | 0 |
| Collagen drsg>16<=48 sq in HCPCS A6022 | $23.29 | $46.58 | not published | 0 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $30.54 | $61.07 | not published | 0 |
| Collar cerv ascend 172 reg HCPCS L0172 | $89.12 | $178.25 | not published | 0 |
| Collar extrication adult univ HCPCS L0200 | $422.28 | $844.56 | not published | 0 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $103.50 | $207.00 | $132.41 – $2,845.00 | 6 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $74.00 | $148.00 | $132.41 – $2,845.00 | 6 |
| Collection of venous blood by venipuncture CPT 36415 | $17.50 | $35.00 | $3.60 – $9.81 | 5 |
| Collj & interpj data ea 30 d CPT 99091 | $86.50 | $173.00 | not published | 0 |
| Colon motility 6 hr study CPT 91117 | not published | not published | $214.89 – $511.00 | 5 |
| Colonoscopy (diagnostic) CPT 45378 | $1,164.50 | $2,329.00 | $925.49 – $3,276.00 | 6 |
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.