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 |
|---|---|---|---|---|
| Gated heart multiple CPT 78473 | $975.00 | $1,950.00 | $397.85 – $409.55 | 4 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | $3.62 | $7.25 | not published | 0 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | $3.62 | $7.25 | not published | 0 |
| Gauze > 48 in no w/sal without b HCPCS A6224 | $3.62 | $7.25 | not published | 0 |
| Gba gene CPT 81251 | not published | not published | $48.20 – $56.70 | 5 |
| Gefitinib oral HCPCS J8565 | not published | not published | $378.98 – $378.98 | 1 |
| Gel-one HCPCS J7326 | not published | not published | $539.84 – $555.72 | 4 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $0.71 – $0.73 | 4 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | not published | not published | $7.98 – $7.98 | 1 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | not published | not published | $227.69 – $248.45 | 4 |
| General health panel CPT 80050 | not published | not published | $51.84 – $115.23 | 2 |
| Generator emblem MRI sicd subq HCPCS C1722 | $20,608.40 | $41,216.81 | not published | 0 |
| Genetic tstg severe inh cond CPT 81443 | $3,159.00 | $6,318.00 | $2,497.53 – $2,938.27 | 5 |
| Genioplasty augmentation CPT 21120 | not published | not published | $5,418.00 – $6,050.24 | 6 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $3,299.54 – $5,978.00 | 6 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $3,299.54 – $5,978.00 | 6 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $5,418.00 – $6,050.24 | 6 |
| Genome re-evaluation CPT 81427 | not published | not published | $0.03 – $2,805.18 | 5 |
| Genome sequence analysis CPT 81425 | not published | not published | $0.03 – $6,037.44 | 5 |
| Genome sequence analysis CPT 81426 | not published | not published | $0.03 – $3,251.94 | 5 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | not published | not published | $6.86 – $6.86 | 1 |
| Gentamicin peak therapeutic drug level CPT 80170 | $97.00 | $194.00 | $16.71 – $27.48 | 5 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $5.89 – $6.06 | 4 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $511.00 – $879.75 | 5 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $511.00 – $2,004.00 | 2 |
| Ghs abscess perianal iandd CPT 46050 | $603.00 | $1,206.00 | $925.49 – $1,547.00 | 6 |
| Ghs abscess postoperative iandd complex CPT 10180 | $4,783.50 | $9,567.00 | $1,571.00 – $5,978.00 | 6 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $36.00 | $72.00 | $10.01 – $12.89 | 5 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $74.00 | $148.00 | $17.45 – $26.94 | 5 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $232.00 | $464.00 | $104.31 – $122.71 | 5 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $116.00 | $232.00 | $132.41 – $136.30 | 4 |
| Ghs antibodies (torch) igm CPT 86694 | $65.00 | $130.00 | $14.68 – $24.13 | 5 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $248.65 – $2,845.00 | 6 |
| Ghs bladder cath - complex-foley CPT 51703 | $497.50 | $995.00 | $128.06 – $1,010.00 | 6 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $4.92 – $7.55 | 5 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,084.00 | $2,168.00 | $702.49 – $1,547.00 | 6 |
| Ghs central line insert < age 5, failed CPT 36555 | $1,842.50 | $3,685.00 | $1,010.00 – $3,227.04 | 6 |
| Ghs change cysto/gastrost CPT 43762 | $904.00 | $1,808.00 | $248.65 – $511.00 | 5 |
| Ghs chemo >8 hrs CPT 96416 | $820.50 | $1,641.00 | $328.72 – $338.39 | 4 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $328.72 – $338.39 | 4 |
| Ghs chemo IV push, ea addtl CPT 96411 | $314.50 | $629.00 | $71.65 – $73.76 | 4 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | not published | not published | $35.79 – $58.85 | 5 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $336.50 | $673.00 | $245.48 – $2,845.00 | 6 |
| Ghs closed reduction ankle dislocation CPT 27840 | $409.00 | $818.00 | $245.48 – $1,010.00 | 6 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $783.50 | $1,567.00 | $1,010.00 – $1,647.34 | 6 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $185.00 | $370.00 | $245.48 – $1,010.00 | 6 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $741.00 | $1,482.00 | $1,010.00 – $3,276.00 | 6 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $2,740.50 | $5,481.00 | $1,571.00 – $3,621.79 | 6 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $336.50 | $673.00 | $245.48 – $1,010.00 | 6 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $741.00 | $1,482.00 | $1,010.00 – $3,276.00 | 6 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $741.00 | $1,482.00 | $1,571.00 – $3,276.00 | 6 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $245.50 | $491.00 | $245.48 – $1,010.00 | 6 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $353.50 | $707.00 | $245.48 – $2,845.00 | 6 |
| Ghs community re-entry 15 minutes CPT 97537 | $46.00 | $92.00 | $32.33 – $33.29 | 4 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $420.50 | $841.00 | $444.58 – $2,845.00 | 6 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $378.50 | $757.00 | $132.41 – $2,845.00 | 6 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $172.50 | $345.00 | $444.58 – $2,845.00 | 6 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $172.50 | $345.00 | $132.41 – $2,845.00 | 6 |
| Ghs cricothyroidotomy CPT 31605 | $1,104.00 | $2,208.00 | $235.71 – $1,010.00 | 6 |
| Ghs cutdown placement age 1 and over CPT 36425 | not published | not published | $444.58 – $2,845.00 | 6 |
| Ghs cutdown placement under 1 yr CPT 36420 | not published | not published | $132.41 – $2,845.00 | 6 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $20.00 | $40.00 | $15.51 – $25.50 | 5 |
| Ghs dislocation elbow closed treatment CPT 24600 | $440.50 | $881.00 | $245.48 – $1,010.00 | 6 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $933.00 | $1,866.00 | $902.63 – $3,276.00 | 6 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $489.00 | $978.00 | $278.35 – $2,845.00 | 6 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,811.00 | $3,622.00 | $702.49 – $1,547.00 | 5 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $3,769.50 | $7,539.00 | $214.89 – $221.21 | 4 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $128.06 – $131.82 | 4 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $128.06 – $131.82 | 4 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | $303.00 | $606.00 | $404.56 – $2,845.00 | 6 |
| Ghs excision ingrown nail CPT 11765 | $367.50 | $735.00 | $404.56 – $2,845.00 | 6 |
| Ghs eye exam CPT 92002 | not published | not published | $132.50 – $136.39 | 4 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $445.50 | $891.00 | $315.88 – $2,845.00 | 6 |
| Ghs fat & muscle CPT 89160 | not published | not published | $4.95 – $6.18 | 5 |
| Ghs fb removal foot - deep - left CPT 28192 | $2,375.00 | $4,750.00 | $1,571.00 – $3,276.00 | 6 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | $2,890.77 – $5,978.00 | 6 |
| Ghs fb removal - incisional CPT 10121 | $1,475.00 | $2,950.00 | $1,571.00 – $3,276.00 | 6 |
| Ghs fb removal - non-incisional CPT 20520 | $1,545.00 | $3,090.00 | $1,010.00 – $1,692.01 | 6 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $26.50 | $53.00 | $7.12 – $11.70 | 5 |
| Ghs fish cytogen CPT 88271 | $125.50 | $251.00 | $21.85 – $35.92 | 5 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $221.50 | $443.00 | $52.21 – $67.33 | 5 |
| Ghs flow volume loop CPT 94375 | not published | not published | $214.89 – $221.21 | 4 |
| Ghs gastric intub aspiration lavage CPT 43753 | $217.00 | $434.00 | $214.89 – $1,010.00 | 6 |
| Ghs hcv amplificaiton CPT 87521 | $159.50 | $319.00 | $35.79 – $58.85 | 5 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $23.43 – $28.86 | 5 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $15.80 – $25.97 | 5 |
| Ghs hgb stability-thal CPT 83068 | not published | not published | $9.66 – $14.20 | 5 |
| Ghs histoplasma antigen CPT 87385 | $57.50 | $115.00 | $13.52 – $20.11 | 5 |
| Ghs HIV antibody CPT 86703 | not published | not published | $13.98 – $23.00 | 5 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $107.94 – $111.45 | 5 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $1,940.50 | $3,881.00 | $1,571.00 – $5,978.00 | 6 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $2,302.00 | $4,604.00 | $1,190.90 – $3,895.00 | 6 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $834.00 | $1,668.00 | $704.73 – $2,845.00 | 6 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $496.00 | $992.00 | $704.73 – $2,845.00 | 6 |
| Ghs immun0electrophoresis CPT 86320 | $18.50 | $37.00 | $30.52 – $37.58 | 5 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $598.00 | $1,196.00 | $248.65 – $1,010.00 | 6 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | not published | not published | $198.65 – $1,571.00 | 6 |
| Ghs inf midline insertion CPT 36140 | $491.00 | $982.00 | $511.00 – $2,004.00 | 2 |
| Ghs inhibitor screen CPT 85335 | $181.50 | $363.00 | $13.13 – $21.59 | 5 |
| Ghs init tx 1st degree burn CPT 16000 | $227.50 | $455.00 | $199.67 – $2,845.00 | 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.