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 |
|---|---|---|---|---|
| Consultation pathology during surgery CPT 88329 | $160.00 | $320.00 | $14.14 – $60.44 | 5 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $394.50 | $789.00 | $32.52 – $823.43 | 5 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $39.50 | $79.00 | $14.14 – $53.58 | 2 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $76.00 | $152.00 | $29.60 – $174.12 | 5 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $142.50 | $285.00 | $41.78 – $53.39 | 5 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | not published | not published | $14.14 – $38.26 | 5 |
| Consult comp w/report rfrd material CPT 88325 | not published | not published | $41.78 – $174.54 | 5 |
| Contact layer >16<= 48 sq in HCPCS A6207 | $96.60 | $193.20 | not published | 0 |
| Contact lens fitg aphakia ou CPT 92312 | not published | not published | $132.41 – $136.30 | 4 |
| Cont intraop neuro monitor HCPCS G0453 | not published | not published | $511.00 – $511.00 | 1 |
| Contour cranial bone lesion CPT 21181 | not published | not published | $5,418.00 – $6,050.24 | 6 |
| Contour of face bone lesion CPT 21029 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Contrast baths charges CPT 97034 | $24.00 | $48.00 | $14.10 – $14.51 | 4 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $1,819.50 | $3,639.00 | $3,142.32 – $3,234.74 | 4 |
| Contrast exam thoracic aorta CPT 75600 | $2,746.50 | $5,493.00 | $3,142.32 – $3,234.74 | 4 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $3,745.00 | $7,490.00 | $5,537.77 – $5,700.64 | 4 |
| Contrast x-ray gallbladder CPT 74290 | not published | not published | $174.56 – $179.69 | 4 |
| Contrast x-ray of ankle CPT 73615 | $349.00 | $698.00 | $347.20 – $357.41 | 4 |
| Contrast x-ray of brain CPT 70010 | not published | not published | $347.20 – $357.41 | 4 |
| Contrast x-ray of brain CPT 70015 | $426.50 | $853.00 | $780.16 – $803.10 | 4 |
| Contrast x-ray of elbow CPT 73085 | $330.50 | $661.00 | $347.20 – $357.41 | 4 |
| Contrast x-ray of hip CPT 73525 | $304.50 | $609.00 | $347.20 – $357.41 | 4 |
| Contrast x-ray of knee joint CPT 73580 | $432.50 | $865.00 | $347.20 – $357.41 | 4 |
| Contrast x-ray of wrist CPT 73115 | $262.50 | $525.00 | $347.20 – $357.41 | 4 |
| Controller infinity pt dbs HCPCS C1787 | $1,368.27 | $2,736.54 | not published | 0 |
| Control nosebleed pack+caut 30905 CPT 30905 | $401.00 | $802.00 | $132.41 – $1,010.00 | 6 |
| Control nose/throat bleeding comp req hospital 42971 CPT 42971 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Control nose/throat bleeding with surg ivntj 42972 CPT 42972 | not published | not published | $3,276.00 – $3,895.00 | 6 |
| Control nose/throat bleeding w/pst nsl packs 42970 CPT 42970 | not published | not published | $235.71 – $2,845.00 | 6 |
| Control of nosebleed ant comp 30903 CPT 30903 | $468.00 | $936.00 | $132.41 – $1,010.00 | 6 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $436.00 | $872.00 | $132.41 – $2,845.00 | 6 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $889.00 | $1,778.00 | $511.00 – $1,010.00 | 6 |
| Control throat bleeding CPT 42961 | not published | not published | $5,978.00 – $5,978.00 | 1 |
| Control throat bleeding CPT 42962 | $4,349.00 | $8,698.00 | $1,571.00 – $5,978.00 | 6 |
| Conversion ext bil drg cath CPT 47535 | $3,931.00 | $7,862.00 | $2,670.00 – $8,246.00 | 6 |
| Convert nephrostomy catheter CPT 50434 | $2,463.50 | $4,927.00 | $1,547.00 – $3,895.00 | 6 |
| Conv gtube to jtube CPT 44373 | $1,186.50 | $2,373.00 | $1,571.00 – $3,276.00 | 6 |
| Coombs direct CPT 86880 | $31.50 | $63.00 | $9.00 – $59.28 | 5 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $25.50 | $51.00 | $9.59 – $171.21 | 5 |
| Coombs indirect titer reference CPT 86886 | $84.00 | $168.00 | $8.68 – $171.21 | 5 |
| Copper cu 64 dotatate diag HCPCS A9592 | $865.72 | $1,731.45 | $606.17 – $623.99 | 4 |
| Copper intrauterine device HCPCS J7300 | not published | not published | $3,018.35 – $3,018.35 | 1 |
| Cor artery disease mrna CPT 81493 | not published | not published | $1,071.00 – $1,250.82 | 5 |
| Core ndl bx lng/med perq CPT 32408 | $1,824.00 | $3,648.00 | $1,643.67 – $3,276.00 | 5 |
| Corf skilled nursing service HCPCS G0128 | $57.00 | $114.00 | not published | 0 |
| Cor hlx vlgs double osteot CPT 28299 | not published | not published | $4,007.00 – $8,246.00 | 6 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Cor hlx vlgs prx phlx osteot CPT 28298 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Corneal hysteresis deter CPT 92145 | not published | not published | $58.71 – $60.44 | 4 |
| Corneal smear CPT 65430 | $399.50 | $799.00 | $444.58 – $2,845.00 | 6 |
| Corneal transplant CPT 65710 | not published | not published | $5,295.75 – $10,995.00 | 6 |
| Corneal transplant CPT 65730 | not published | not published | $4,113.58 – $10,995.00 | 6 |
| Corneal transplant CPT 65750 | not published | not published | $5,295.75 – $10,995.00 | 6 |
| Corneal transplant CPT 65755 | not published | not published | $4,113.58 – $10,995.00 | 6 |
| Corneal trnspl endothelial CPT 65756 | not published | not published | $4,113.58 – $10,995.00 | 6 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $8,131.00 | $16,262.00 | $3,226.37 – $10,995.00 | 5 |
| Coronary angio/lv gram/lt heart CPT 93458 | $7,921.50 | $15,843.00 | $3,226.37 – $10,995.00 | 5 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $9,576.50 | $19,153.00 | $3,226.37 – $10,995.00 | 5 |
| Coronary artery correction CPT 33502 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Coronary artery graft CPT 33503 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Coronary artery graft CPT 33504 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Coronary art/grft angio s&i CPT 93455 | $3,739.50 | $7,479.00 | $3,226.37 – $10,995.00 | 5 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $3,530.00 | $7,060.00 | $3,226.37 – $10,995.00 | 5 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | not published | not published | $511.00 – $511.00 | 1 |
| Coroners autopsy (necropsy) CPT 88045 | not published | not published | $53.66 – $143.36 | 2 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Correct cock-up 5th toe/plast clos 28286 CPT 28286 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Correct finger deformity CPT 26567 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Correct inverted nipple(s) CPT 19355 | not published | not published | $3,338.00 – $8,246.00 | 6 |
| Correction claw finger other CPT 26499 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Correction eyelid w/implant CPT 67912 | not published | not published | $2,366.07 – $5,978.00 | 6 |
| Correction hallux valgus sesamoidectomy;prox meta osteotomy CPT 28295 | not published | not published | $2,670.00 – $8,246.00 | 6 |
| Correction of astigmatism CPT 65772 | not published | not published | $992.09 – $4,314.00 | 6 |
| Correction of astigmatism CPT 65775 | not published | not published | $2,366.07 – $5,978.00 | 6 |
| Correction of bladder defect CPT 51940 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Correction of everted punctum 68705 CPT 68705 | not published | not published | $315.88 – $1,010.00 | 6 |
| Correction trichiasis epilation forcep 67820 CPT 67820 | not published | not published | $132.41 – $2,845.00 | 6 |
| Correction trichiasis inccision lid margin 67830 CPT 67830 | not published | not published | $992.09 – $3,276.00 | 6 |
| Correct malrotation of bowel 44055 CPT 44055 | not published | not published | $1,547.00 – $5,980.00 | 2 |
| Correct metacarpal flaw CPT 26565 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Correct rectal prolapse CPT 45541 | not published | not published | $2,670.00 – $8,246.00 | 5 |
| Correct rectal prolapse; abdominal approach 45540 CPT 45540 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Correct skin color 6.0 cm/< CPT 11920 | not published | not published | $511.00 – $2,845.00 | 6 |
| Correct skin color ea 20.0cm CPT 11922 | not published | not published | $511.00 – $2,004.00 | 2 |
| Corrj halux rigdus w/implt CPT 28291 | not published | not published | $3,304.00 – $13,397.00 | 5 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Corticorelin ovine triflutal HCPCS J0795 | not published | not published | $24.67 – $24.67 | 1 |
| Cortisol acth stimulation test - sendout CPT 80400 | not published | not published | $33.27 – $54.67 | 5 |
| Cortisol total am CPT 82533 | $74.50 | $149.00 | $16.63 – $27.34 | 5 |
| Costotransversectomy CPT 21610 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | not published | not published | $93.02 – $93.02 | 1 |
| Co-treatment - group 15 mins, st CPT 92508 | $373.00 | $746.00 | $24.20 – $24.92 | 4 |
| Counseling smoke cess interm >10mins CPT 99407 | $44.50 | $89.00 | not published | 0 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $3,657.50 | $7,315.00 | not published | 0 |
| Cover eye w/membrane CPT 65778 | not published | not published | $992.09 – $3,276.00 | 6 |
| Cover eye w/membrane suture CPT 65779 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $20.00 | $40.00 | not published | 0 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $225.00 | $450.00 | not published | 0 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | $225.00 | $450.00 | not published | 0 |
| Covid-19 lab test non-cdc HCPCS U0002 | not published | not published | $52.34 – $61.57 | 5 |
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.