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 |
|---|---|---|---|---|
| Flexible Sigmoidoscopy CPT 45330 | $839.00 | $1,678.00 | $925.49 – $1,547.00 | 6 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Flex thermoplastic collar mo HCPCS L0130 | $118.51 | $237.02 | not published | 0 |
| Floor of mouth biopsy 41108 CPT 41108 | $2,374.50 | $4,749.00 | $1,010.00 – $1,692.01 | 6 |
| Florbetaben f18 diagnostic HCPCS Q9983 | not published | not published | $1,616.36 – $1,663.90 | 4 |
| Flortaucipir inj 1 millicuri HCPCS A9601 | not published | not published | $3,784.20 – $3,895.50 | 4 |
| Flotufolastat f18 diag 1 mci HCPCS A9608 | $523.95 | $1,047.90 | $684.64 – $704.78 | 4 |
| Flow cytometry interp 16 or more CPT 88189 | not published | not published | $41.78 – $217.07 | 2 |
| Flow cytometry marker each additional CPT 88185 | $93.00 | $186.00 | $14.14 – $60.69 | 2 |
| Flow cytometry one marker technical component CPT 88184 | $209.50 | $419.00 | $14.14 – $366.34 | 5 |
| #flow interp 9 - 15 markers CPT 88188 | not published | not published | $14.14 – $162.06 | 2 |
| Floxuridine injection HCPCS J9200 | not published | not published | $4,210.58 – $4,334.42 | 4 |
| Flt3 gene CPT 81245 | not published | not published | $168.82 – $199.10 | 5 |
| Flt3 gene analysis CPT 81246 | not published | not published | $84.66 – $99.65 | 5 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | not published | not published | $6.63 – $6.63 | 1 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | not published | not published | $135.42 – $468.31 | 2 |
| Fluidotherapy charges pt CPT 97022 | $33.00 | $66.00 | $15.75 – $16.21 | 4 |
| Fluid pressure muscle 20950 CPT 20950 | $339.50 | $679.00 | $704.73 – $1,547.00 | 6 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $486.87 – $523.04 | 4 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $328.91 – $357.33 | 4 |
| Fluorescein angioscopy i&r CPT 92230 | $592.50 | $1,185.00 | $371.37 – $382.29 | 4 |
| Fluorescein angrph mltiframe CPT 92235 | not published | not published | $214.89 – $221.21 | 4 |
| Fluorescein&icg angiography CPT 92242 | not published | not published | $214.89 – $221.21 | 4 |
| Fluorescent antibody titer dna CPT 86256 | $57.50 | $115.00 | $12.29 – $20.21 | 5 |
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $872.66 – $898.33 | 4 |
| Fluoroestradiol f 18 HCPCS A9591 | $643.50 | $1,287.00 | $469.63 – $483.44 | 4 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $146.50 | $293.00 | not published | 0 |
| Fluoroguide needle placement CPT 77002 | $213.50 | $427.00 | not published | 0 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $19.29 – $31.72 | 5 |
| Fluoroscopy up to 1 hour CPT 76000 | $189.50 | $379.00 | $237.46 – $244.44 | 4 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | not published | not published | $6.20 – $6.20 | 1 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | not published | not published | $26.18 – $26.18 | 1 |
| Flurpiridaz f18, diag, 1 mci HCPCS A9611 | not published | not published | $540.60 – $556.50 | 4 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | not published | not published | $1,982.89 – $2,041.21 | 4 |
| Fmri brain by phys/psych CPT 70555 | $1,639.00 | $3,278.00 | $237.46 – $244.44 | 4 |
| Fmri brain by tech CPT 70554 | $2,034.50 | $4,069.00 | $237.46 – $244.44 | 4 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,119.00 | $2,238.00 | $704.73 – $1,547.00 | 5 |
| Fna bx w/ct gdn ea addl CPT 10010 | $596.50 | $1,193.00 | $511.00 – $2,004.00 | 2 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $704.73 – $1,547.00 | 5 |
| Fna bx w/mr gdn ea addl CPT 10012 | not published | not published | $511.00 – $2,004.00 | 2 |
| Foam drg >16<=48 sq in w/bdr HCPCS A6213 | $7.76 | $15.53 | not published | 0 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | $21.74 | $43.47 | not published | 0 |
| Foam drg <=16 sq in w/border HCPCS A6212 | $8.28 | $16.56 | not published | 0 |
| Foam drg > 48 sq in w/border HCPCS A6214 | $6.73 | $13.46 | not published | 0 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | $32.08 | $64.17 | not published | 0 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | $21.74 | $43.47 | not published | 0 |
| Foam stability fetal lung CPT 83662 | not published | not published | $19.29 – $31.72 | 5 |
| Folic acid CPT 82746 | $82.00 | $164.00 | $14.99 – $24.65 | 5 |
| Follow-up angiography CPT 75898 | $1,619.50 | $3,239.00 | $3,142.32 – $3,234.74 | 4 |
| Followup eval of foot pt lop HCPCS G0246 | $58.00 | $116.00 | $132.50 – $136.39 | 4 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | not published | not published | $6.40 – $6.59 | 4 |
| Fondaparinux sodium HCPCS J1652 | not published | not published | $1.88 – $1.88 | 1 |
| Fo nontorsion joint cf HCPCS L3935 | $34.16 | $68.31 | not published | 0 |
| Foot arch support remov prem HCPCS L3030 | $160.42 | $320.85 | not published | 0 |
| Foot arch supp premold metat HCPCS L3050 | $26.91 | $53.82 | not published | 0 |
| Foot plas heel stabi pre ots HCPCS L3170 | $26.50 | $53.00 | not published | 0 |
| Foot X-ray CPT 73630 | $221.00 | $442.00 | $86.61 – $89.15 | 4 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | $669.13 | $1,338.26 | not published | 0 |
| Forearm/arm cuffs free motio HCPCS L3720 | $349.32 | $698.63 | not published | 0 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $643.96 – $1,433.71 | 2 |
| Forensic cytopathology CPT 88125 | not published | not published | $14.14 – $53.26 | 5 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $725.00 | $1,450.00 | $248.65 – $1,010.00 | 6 |
| Formoterol comp unit HCPCS J7640 | not published | not published | $6.65 – $6.65 | 1 |
| Formoterol fumarate, inh HCPCS J7606 | not published | not published | $5.25 – $5.25 | 1 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | not published | not published | $0.34 – $0.34 | 1 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $29.45 – $106.50 | 2 |
| Fractionation ketosteroids CPT 83593 | $119.50 | $239.00 | $29.07 – $44.10 | 5 |
| Fracture assessment via dxa CPT 77086 | $149.50 | $299.00 | $86.61 – $89.15 | 4 |
| _fragile x methylation-sendout CPT 81244 | not published | not published | $45.79 – $53.87 | 5 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $3,508.06 – $13,397.00 | 6 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $3,304.00 – $5,978.00 | 2 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $1,547.00 – $5,980.00 | 2 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $3,304.00 – $5,978.00 | 2 |
| Free omental flap microvasc CPT 49906 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Free skin flap microvasc CPT 15757 | not published | not published | $3,304.00 – $5,978.00 | 2 |
| Frenectomy 41115 CPT 41115 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Frenotomy 40806 CPT 40806 | not published | not published | $511.00 – $2,845.00 | 6 |
| Frenulotomy of penis CPT 54164 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $187.50 | $375.00 | not published | 0 |
| Fresh frozen plasma thawing ea un CPT 86927 | $82.50 | $165.00 | $24.52 – $174.12 | 5 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $37.17 – $64.18 | 5 |
| Frozen blood prep CPT 86930 | not published | not published | $64.18 – $174.54 | 5 |
| Frozen blood thaw CPT 86931 | not published | not published | $64.18 – $174.54 | 5 |
| Frozen cell preparation CPT 88241 | not published | not published | $12.33 – $16.93 | 5 |
| Frozen plasma, pooled, sd HCPCS P9023 | $193.50 | $387.00 | not published | 0 |
| Fructosamine glycated protein CPT 82985 | $66.00 | $132.00 | $17.10 – $25.27 | 5 |
| Ft arch suprt premold longit HCPCS L3040 | $30.02 | $60.03 | not published | 0 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | $1,417.00 | $2,834.00 | $511.00 – $2,670.00 | 2 |
| Fth/gft fr trnk each addl CPT 15201 | $1,417.00 | $2,834.00 | $511.00 – $2,670.00 | 2 |
| Ftl cgen abnor 3 proteins CPT 81509 | not published | not published | $1,517.12 – $1,784.84 | 5 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $70.91 – $83.42 | 5 |
| Ftl cgen abnor four anal CPT 81511 | $133.00 | $266.00 | $156.57 – $184.20 | 5 |
| Ftl cgen abnor three anal CPT 81510 | not published | not published | $56.65 – $66.65 | 5 |
| Ftl cgen abnor two proteins CPT 81508 | $109.00 | $218.00 | $55.39 – $65.16 | 5 |
| Full field erg w/i&r CPT 92273 | not published | not published | $214.89 – $221.21 | 4 |
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.