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 |
|---|---|---|---|---|
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Dilation of salivary duct CPT 42660 | not published | not published | $511.00 – $2,845.00 | 6 |
| Dilation of urethra CPT 53661 | $132.00 | $264.00 | $132.41 – $2,845.00 | 6 |
| Dilation of urethra CPT 53665 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Dilation of vagina CPT 57400 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Dilation salivary duct 42650 CPT 42650 | $967.00 | $1,934.00 | $1,010.00 – $3,276.00 | 6 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $1,134.50 | $2,269.00 | $693.95 – $1,547.00 | 5 |
| Dilator fascial 10fx20cm HCPCS C2627 | $402.10 | $804.20 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,530.00 | $7,060.00 | $2,004.00 – $5,978.00 | 5 |
| Dilat xst trc new access rcs CPT 50437 | $3,883.50 | $7,767.00 | $2,670.00 – $8,246.00 | 5 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $144.56 – $144.56 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $24.14 – $24.14 | 1 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $763.82 – $786.29 | 4 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | not published | not published | $2.04 – $2.04 | 1 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $10.76 – $10.76 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $37.17 – $38.26 | 4 |
| Disability dlco CPT 94727 | $154.50 | $309.00 | $214.89 – $221.21 | 4 |
| Disaccharidases CPT 82657 | $272.50 | $545.00 | $22.61 – $30.28 | 5 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Disarticulation shoulder CPT 23920 | not published | not published | $12,777.04 – $13,397.00 | 5 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Discography cerv/thor spine CPT 72285 | $2,149.00 | $4,298.00 | $1,943.35 – $2,000.51 | 4 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $511.00 – $1,823.45 | 5 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $3,338.00 – $13,397.00 | 5 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $4,007.00 – $10,995.00 | 5 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $2,670.00 – $3,276.00 | 2 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.03 – $29.64 | 2 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $750.50 | $1,501.00 | $1,547.00 – $2,004.00 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $168.17 – $292.95 | 5 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $280.33 – $329.80 | 5 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $139.74 – $164.40 | 5 |
| Dna antibody native/double stranded CPT 86225 | $59.00 | $118.00 | $14.01 – $23.04 | 5 |
| Dna gardnerella CPT 87510 | $100.00 | $200.00 | $20.45 – $33.62 | 5 |
| Dna probe chlamydia CPT 87490 | not published | not published | $23.20 – $33.62 | 5 |
| Dna probe gc CPT 87590 | not published | not published | $27.42 – $33.62 | 5 |
| Dna trichomonas CPT 87660 | $100.00 | $200.00 | $20.45 – $33.62 | 5 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | not published | not published | $20.56 – $20.56 | 1 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | not published | not published | $2.04 – $2.04 | 1 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $51.79 – $53.32 | 4 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $15.85 – $15.85 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | not published | not published | $2.15 – $2.15 | 1 |
| Doppler echo complete CPT 93320 | $259.00 | $518.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $2,366.00 | $4,732.00 | $511.00 – $511.00 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $512.00 | $1,024.00 | $214.89 – $221.21 | 4 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $225.00 | $450.00 | $132.41 – $136.30 | 4 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $2.15 – $2.15 | 1 |
| Dornase alfa non-comp unit HCPCS J7639 | not published | not published | $149.12 – $149.12 | 1 |
| Dorsi & plantar flex ass/res HCPCS L2220 | $67.28 | $134.55 | not published | 0 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $248.59 – $255.90 | 4 |
| Double transfer toe-hand CPT 26554 | not published | not published | $3,338.00 – $10,995.00 | 5 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | not published | not published | $9.25 – $9.25 | 1 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $110.64 – $113.89 | 4 |
| Dpyd gene common variants CPT 81232 | $774.50 | $1,549.00 | $178.31 – $209.77 | 5 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $360.00 | $720.00 | $704.73 – $2,845.00 | 6 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $497.00 | $994.00 | $704.73 – $2,845.00 | 6 |
| Drainage external ear complex 69005 CPT 69005 | $1,437.00 | $2,874.00 | $1,643.67 – $3,276.00 | 5 |
| Drainage external ear simple 69000 CPT 69000 | $497.00 | $994.00 | $704.73 – $2,845.00 | 6 |
| Drainage lymph node lesion 38300 CPT 38300 | $1,393.00 | $2,786.00 | $1,010.00 – $3,276.00 | 6 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Drainage mouth roof lesion CPT 42000 | $375.00 | $750.00 | $235.71 – $1,571.00 | 6 |
| Drainage of abdomen CPT 48000 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Drainage of arm bursa 23931 CPT 23931 | $1,385.50 | $2,771.00 | $1,571.00 – $3,276.00 | 6 |
| Drainage of bladder abscess CPT 51080 | $1,385.50 | $2,771.00 | $1,010.00 – $3,276.00 | 6 |
| Drainage of bone lesion CPT 26992 | not published | not published | $2,670.00 – $10,995.00 | 5 |
| Drainage of bone lesion CPT 27303 | not published | not published | $2,670.00 – $10,995.00 | 5 |
| Drainage of eye CPT 65800 | $1,201.00 | $2,402.00 | $511.00 – $2,358.66 | 6 |
| Drainage of eye CPT 65810 | $2,081.50 | $4,163.00 | $2,296.74 – $5,978.00 | 6 |
| Drainage of eye CPT 65815 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Drainage of kidney lesion CPT 50390 | $1,085.00 | $2,170.00 | $704.73 – $1,547.00 | 6 |
| Drainage of mouth lesion CPT 41005 | $316.50 | $633.00 | $235.71 – $1,010.00 | 6 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Drainage of mouth lesion CPT 41007 | $2,506.00 | $5,012.00 | $1,010.00 – $3,276.00 | 6 |
| Drainage of mouth lesion CPT 41008 | $2,187.50 | $4,375.00 | $1,010.00 – $3,388.50 | 6 |
| Drainage of mouth lesion CPT 41009 | $382.00 | $764.00 | $511.00 – $1,010.00 | 6 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $511.00 – $1,010.00 | 6 |
| Drainage of mouth lesion CPT 41016 | $2,758.00 | $5,516.00 | $1,010.00 – $6,050.24 | 6 |
| Drainage of mouth lesion CPT 41017 | $1,699.50 | $3,399.00 | $1,010.00 – $3,388.50 | 6 |
| Drainage of mouth lesion CPT 41018 | $2,283.50 | $4,567.00 | $1,010.00 – $3,276.00 | 6 |
| Drainage of nose lesion int 30000 CPT 30000 | $382.00 | $764.00 | $235.71 – $2,845.00 | 6 |
| Drainage of nose lesion sept 30020 CPT 30020 | $382.00 | $764.00 | $511.00 – $2,845.00 | 6 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Drainage of pelvis lesion 26990 CPT 26990 | $2,671.00 | $5,342.00 | $1,010.00 – $5,978.00 | 6 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Drainage of rectal abscess CPT 45005 | $559.50 | $1,119.00 | $1,190.90 – $3,276.00 | 6 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Drainage of salivary gland CPT 42305 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Drainage of salivary gland CPT 42320 | not published | not published | $511.00 – $1,010.00 | 6 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Drainage of spinal cyst CPT 63173 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Drainage of throat abscess CPT 42725 | not published | not published | $1,571.00 – $10,995.00 | 6 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $1,571.00 – $5,978.00 | 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.