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 |
|---|---|---|---|---|
| Cystoscopy and treatment CPT 52276 | not published | not published | $2,080.35 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $693.95 – $3,276.00 | 6 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52310 | $1,743.00 | $3,486.00 | $1,571.00 – $3,276.00 | 6 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $3,508.06 – $5,978.00 | 6 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,262.00 | $2,524.00 | $693.95 – $1,547.00 | 6 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $2,080.35 – $4,441.00 | 6 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $693.95 – $1,571.00 | 6 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $3,304.00 – $6,716.00 | 6 |
| Cystoscopy inject material CPT 52327 | not published | not published | $1,571.00 – $10,995.00 | 6 |
| Cystoscopy prostatic imp 1-3 HCPCS C9739 | not published | not published | $3,338.00 – $6,716.00 | 6 |
| Cystoscopy removal of clots CPT 52001 | $1,743.00 | $3,486.00 | $1,571.00 – $3,602.64 | 6 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Cystoscopy & ureter catheter CPT 52005 | $1,743.00 | $3,486.00 | $1,571.00 – $5,978.00 | 6 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | not published | not published | $2,080.35 – $5,978.00 | 6 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $3,508.06 – $5,978.00 | 5 |
| Cystouretero & or pyeloscope CPT 52351 | $1,743.00 | $3,486.00 | $3,304.00 – $5,978.00 | 6 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $3,338.00 – $10,995.00 | 6 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $3,338.00 – $10,995.00 | 6 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $1,683.50 | $3,367.00 | $1,571.00 – $3,276.00 | 6 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $511.00 – $2,004.00 | 2 |
| Cystourethro w/implant CPT 52441 | not published | not published | $511.00 – $3,304.00 | 2 |
| Cysto with bx(s) with blue light HCPCS C7550 | not published | not published | $1,547.00 – $2,670.00 | 2 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Cysto w/ureter stricture tx CPT 52341 | $2,785.50 | $5,571.00 | $3,304.00 – $5,978.00 | 6 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | not published | not published | $2.20 – $2.20 | 1 |
| Cytarabine liposome inj HCPCS J9098 | not published | not published | $1,602.35 – $1,602.35 | 1 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,221.90 – $1,392.00 | 5 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $43.23 – $58.36 | 5 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $41.51 – $44.89 | 5 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,183.20 – $1,392.00 | 5 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $918.00 – $1,080.00 | 5 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,900.48 – $1,956.38 | 4 |
| Cytomegalovirus ag ia CPT 87332 | $58.50 | $117.00 | $12.22 – $20.11 | 5 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $65.00 | $130.00 | $14.68 – $24.13 | 5 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $15.50 | $31.00 | $17.19 – $28.25 | 5 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.69 – $20.11 | 5 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,810.96 – $1,899.08 | 4 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $30.63 – $33.62 | 5 |
| Cyto/molecular report CPT 88291 | not published | not published | $32.29 – $83.20 | 2 |
| Cytopath c/v auto in fluid CPT 88174 | $20.00 | $40.00 | $25.88 – $35.82 | 5 |
| Cytopath c/v automated CPT 88147 | not published | not published | $19.08 – $53.09 | 5 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $17.71 – $29.02 | 5 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $18.91 – $25.48 | 5 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $10.04 – $15.38 | 5 |
| Cytopath c/v manual CPT 88150 | $20.00 | $40.00 | $17.71 – $19.47 | 5 |
| Cytopath c/v redo CPT 88153 | not published | not published | $17.71 – $25.23 | 5 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $23.50 – $33.97 | 5 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $28.78 – $29.63 | 5 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $438.00 | $876.00 | $29.60 – $53.39 | 5 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $15.50 | $31.00 | $27.14 – $44.41 | 5 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $26.00 | $52.00 | $20.67 – $33.97 | 5 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $74.00 | $148.00 | $29.60 – $38.26 | 5 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $62.50 | $125.00 | $29.60 – $38.26 | 5 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $24.00 | $48.00 | $13.25 – $17.59 | 2 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $96.00 | $192.00 | $29.60 – $174.12 | 5 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $98.00 | $196.00 | $29.60 – $53.39 | 5 |
| Cytopath smear other source CPT 88160 | $91.00 | $182.00 | $14.14 – $29.63 | 5 |
| Cytopath smear other source CPT 88162 | not published | not published | $14.14 – $53.39 | 5 |
| Cytopath smear oth prep screen & interp CPT 88161 | $50.00 | $100.00 | $28.78 – $29.63 | 5 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $17.71 – $19.47 | 5 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $17.71 – $19.47 | 5 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $17.71 – $44.33 | 5 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $17.71 – $19.47 | 5 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $66.35 – $82.58 | 5 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $30.27 – $49.76 | 5 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $1,535.00 | $3,070.00 | $67.70 – $174.54 | 5 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $11.61 – $11.61 | 1 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $334.90 – $344.75 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | not published | not published | $15.93 – $16.39 | 4 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $38.58 – $38.58 | 1 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | not published | not published | $0.11 – $0.11 | 1 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.09 – $0.09 | 1 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $56.68 – $58.35 | 4 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | not published | not published | $2.98 – $3.07 | 4 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.98 – $3.07 | 4 |
| Dark field exam spec collj CPT 87164 | not published | not published | $10.95 – $18.01 | 5 |
| Dark field exam without collj CPT 87166 | not published | not published | $11.53 – $18.94 | 5 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $249.61 – $268.89 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $37.35 – $65.43 | 2 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $621.69 – $621.69 | 1 |
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.