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 |
|---|---|---|---|---|
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $3,304.00 – $13,397.00 | 5 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $287.73 | $575.46 | not published | 0 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $1,008.15 | $2,016.30 | not published | 0 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $205.45 | $410.90 | not published | 0 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $739.70 | $1,479.40 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $173.36 | $346.73 | not published | 0 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $173.36 | $346.73 | not published | 0 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $37.17 – $38.26 | 4 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.57 – $5.73 | 4 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $265.00 | $530.00 | $65.70 – $107.99 | 5 |
| Alpha-fetoprotein amniotic CPT 82106 | $77.00 | $154.00 | $17.34 – $28.13 | 5 |
| Alpha-fetoprotein tumor marker CPT 82105 | $77.00 | $154.00 | $17.11 – $28.13 | 5 |
| Alprostadil for injection HCPCS J0270 | not published | not published | $10.48 – $27.77 | 2 |
| Alprostadil urethral suppos HCPCS J0275 | not published | not published | $110.85 – $110.85 | 1 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | not published | not published | $96.34 – $99.17 | 4 |
| Alt/sgpt CPT 84460 | $24.50 | $49.00 | $5.41 – $8.88 | 5 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.76 – $4.90 | 4 |
| Aluminum - quest CPT 82108 | $114.50 | $229.00 | $25.99 – $42.72 | 5 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $2,004.00 – $3,388.50 | 5 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $444.50 | $889.00 | not published | 0 |
| Amantadine (symmetrel)-sendout CPT 80375 | not published | not published | $0.03 – $26.59 | 2 |
| Ambl bp mntr w/sw a/r CPT 93788 | $73.50 | $147.00 | $132.41 – $136.30 | 4 |
| Amifostine HCPCS J0207 | not published | not published | $2,896.03 – $2,896.03 | 1 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | not published | not published | $1.51 – $1.51 | 1 |
| Amines vaginal fluid qual CPT 82120 | not published | not published | $6.11 – $6.30 | 5 |
| Amino acid screen, urine CPT 82128 | not published | not published | $14.15 – $23.24 | 5 |
| Amino acid single qual CPT 82127 | not published | not published | $14.46 – $23.24 | 5 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $20.00 – $28.28 | 5 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.83 – $1.88 | 4 |
| Aminolevulinic acid delta CPT 82135 | $68.50 | $137.00 | $16.78 – $27.60 | 5 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $399.93 – $411.69 | 4 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | not published | not published | $14.39 – $14.39 | 1 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | not published | not published | $7.02 – $7.02 | 1 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | not published | not published | $1.09 – $1.09 | 1 |
| Amitriptyline (elavil) -sendout CPT 80335 | not published | not published | $0.03 – $29.23 | 2 |
| Amitriptyline injection HCPCS J1320 | not published | not published | $5.94 – $5.94 | 1 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | not published | not published | $22.99 – $23.67 | 4 |
| Ammonia CPT 82140 | $63.50 | $127.00 | $14.86 – $24.43 | 5 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $1,715.50 | $3,431.00 | $916.63 – $1,547.00 | 5 |
| Amniocentesis therapeutic CPT 59001 | $1,974.00 | $3,948.00 | $303.27 – $511.00 | 5 |
| Amniotic fluid scan CPT 82143 | not published | not published | $9.54 – $11.53 | 5 |
| Amobarbital 125 mg inj HCPCS J0300 | not published | not published | $495.36 – $495.36 | 1 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $2,563.00 | $5,126.00 | $3,256.29 – $4,314.00 | 6 |
| Amphetamine confirm urine -sendout CPT 80324 | not published | not published | $0.03 – $25.38 | 2 |
| Amphetamines 5 or more CPT 80326 | not published | not published | $0.03 – $25.38 | 2 |
| Ampho b cholesteryl sulfate HCPCS J0288 | not published | not published | $36.04 – $36.04 | 1 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | not published | not published | $139.31 – $139.31 | 1 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $10.50 – $10.81 | 4 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $21.91 – $22.56 | 4 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | not published | not published | $1.99 – $1.99 | 1 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | not published | not published | $4.56 – $4.56 | 1 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $268.25 – $276.14 | 4 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputate hand at wrist CPT 25922 | not published | not published | $1,600.27 – $5,978.00 | 6 |
| Amputate hand at wrist CPT 25920 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputate leg at thigh CPT 27591 | not published | not published | $3,256.29 – $29,725.00 | 5 |
| Amputate leg at thigh CPT 27592 | not published | not published | $3,256.29 – $29,725.00 | 5 |
| Amputate lower leg at knee CPT 27598 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $3,256.29 – $29,725.00 | 5 |
| Amputate upper arm & implant CPT 24931 | not published | not published | $12,777.04 – $13,397.00 | 5 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $3,304.00 – $7,416.07 | 5 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $3,256.29 – $5,978.00 | 5 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Amputation follow-up surgery CPT 24930 | not published | not published | $7,221.37 – $13,397.00 | 5 |
| Amputation follow-up surgery CPT 25924 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $7,221.37 – $29,725.00 | 5 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Amputation of foot at ankle CPT 27888 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputation of forearm CPT 25900 | not published | not published | $7,221.37 – $13,397.00 | 5 |
| Amputation of forearm CPT 25905 | not published | not published | $7,221.37 – $13,397.00 | 5 |
| Amputation of forearm CPT 25915 | not published | not published | $7,221.37 – $13,397.00 | 5 |
| Amputation of hand CPT 25927 | not published | not published | $3,256.29 – $8,246.00 | 5 |
| Amputation of leg at hip CPT 27290 | not published | not published | $17,449.63 – $29,725.00 | 5 |
| Amputation of leg at hip CPT 27295 | not published | not published | $17,449.63 – $29,725.00 | 5 |
| Amputation of lower leg CPT 27882 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputation of lower leg CPT 27881 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $3,256.29 – $8,246.00 | 5 |
| Amputation of upper arm CPT 24900 | not published | not published | $12,777.04 – $13,397.00 | 5 |
| Amputation of upper arm CPT 24920 | not published | not published | $12,777.04 – $13,397.00 | 5 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $3,256.29 – $5,978.00 | 5 |
| Amputation toe interphalangeal joint CPT 28825 | $3,922.00 | $7,844.00 | $1,571.00 – $5,978.00 | 6 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $3,922.00 | $7,844.00 | $1,571.00 – $5,978.00 | 6 |
| Amylase CPT 82150 | $31.50 | $63.00 | $6.61 – $10.87 | 5 |
| Anabolic steroid 1 or 2 CPT 80327 | not published | not published | $0.03 – $42.16 | 2 |
| Anabolic steroid 3 or more CPT 80328 | not published | not published | $0.03 – $42.16 | 2 |
| Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 | not published | not published | $59.47 – $61.22 | 4 |
| Ana ds-dna CPT 86226 | $54.00 | $108.00 | $12.35 – $20.30 | 5 |
| Analgesics non-opioid 3-5 CPT 80330 | not published | not published | $0.03 – $33.05 | 2 |
| Analgesics non-opioid 6/more CPT 80331 | not published | not published | $0.03 – $33.05 | 2 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | not published | not published | $0.03 – $33.05 | 2 |
| Anal pressure record CPT 91122 | $317.50 | $635.00 | $511.00 – $511.00 | 1 |
| Anal/urinary muscle study CPT 51784 | not published | not published | $128.06 – $2,845.00 | 6 |
| Anal/urinary muscle study CPT 51785 | $494.00 | $988.00 | $248.65 – $1,010.00 | 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.