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 |
|---|---|---|---|---|
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $10,995.00 – $10,995.00 | 1 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,909.69 – $5,978.00 | 5 |
| G-tube reposition CPT 43761 | $504.00 | $1,008.00 | $248.65 – $1,010.00 | 6 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,021.00 | $2,042.00 | $2,080.35 – $2,141.53 | 4 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,170.50 | $4,341.00 | $704.73 – $2,845.00 | 6 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $754.52 | $1,509.03 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $288.25 | $576.50 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $530.00 | $1,060.00 | not published | 0 |
| Gum graft CPT 41870 | not published | not published | $1,544.13 – $3,276.00 | 5 |
| Gw stiffened micro access kit HCPCS C1894 | $910.80 | $1,821.60 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Hair analysis HCPCS P2031 | not published | not published | $7.33 – $13.63 | 3 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $511.00 – $2,845.00 | 6 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $404.56 – $3,895.00 | 6 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $404.56 – $3,895.00 | 6 |
| Halo cervical into jckt vest HCPCS L0810 | $1,975.30 | $3,950.60 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $15.42 – $15.42 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $3.37 – $3.37 | 1 |
| Hand-held pefr meter a4614 HCPCS A4614 | $26.40 | $52.79 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $8.18 – $8.18 | 1 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $47.50 | $95.00 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $1,487.82 | $2,975.63 | not published | 0 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $3,276.00 – $7,416.07 | 6 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Hand X-ray CPT 73130 | $203.00 | $406.00 | $86.61 – $89.15 | 4 |
| Haptoglobin quantitative CPT 83010 | $64.00 | $128.00 | $12.83 – $21.10 | 5 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $511.00 – $511.00 | 1 |
| Harvest auto stem cells CPT 38206 | $2,999.00 | $5,998.00 | $1,549.95 – $3,276.00 | 5 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $511.00 – $511.00 | 1 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $439.06 – $1,010.00 | 6 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $511.00 – $511.00 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | $149.00 | $298.00 | $132.41 – $136.30 | 4 |
| Hast w/oxygen titrate CPT 94453 | $219.00 | $438.00 | $132.41 – $136.30 | 4 |
| Hba1/hba2 full gene sequence CPT 81259 | $230.50 | $461.00 | $612.00 – $720.00 | 5 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $206.45 – $242.88 | 5 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $382.76 – $450.30 | 5 |
| Hbb full gene sequence CPT 81364 | $1,144.00 | $2,288.00 | $331.07 – $389.50 | 5 |
| Hbb gene com variants CPT 81361 | not published | not published | $178.31 – $209.77 | 5 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $206.45 – $242.88 | 5 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $382.76 – $450.30 | 5 |
| Hb glycosylated a1c home dev CPT 83037 | $11.00 | $22.00 | $9.90 – $23.65 | 5 |
| Hbot, full body chamber, 30m HCPCS G0277 | $286.00 | $572.00 | $136.95 – $140.98 | 4 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $407.50 | $815.00 | $174.56 – $179.69 | 4 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.60 – $25.24 | 5 |
| Hcg qualitative CPT 84703 | $35.00 | $70.00 | $7.67 – $12.59 | 5 |
| Hcg quantitative CPT 84702 | $205.50 | $411.00 | $15.35 – $25.24 | 5 |
| Hc hearing aid exam both ears CPT 92591 | $163.50 | $327.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $25.00 | $50.00 | not published | 0 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $511.00 – $1,010.00 | 6 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $511.00 – $2,004.00 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $511.00 – $1,010.00 | 6 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $511.00 – $2,004.00 | 2 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $511.00 – $2,004.00 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $540.36 – $556.26 | 4 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $397.85 – $409.55 | 4 |
| Hc nm kidney imaging with flow CPT 78701 | $512.50 | $1,025.00 | $397.85 – $409.55 | 4 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $540.36 – $556.26 | 4 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $1,288.43 – $1,326.33 | 4 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | not published | not published | $511.00 – $2,004.00 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $1,197.50 | $2,395.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $2,177.50 | $4,355.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $3,400.50 | $6,801.00 | not published | 0 |
| Hdr rdncl skn surf brachytx CPT 77767 | $925.00 | $1,850.00 | $383.84 – $395.13 | 4 |
| Hdr rdncl skn surf brachytx CPT 77768 | $1,520.50 | $3,041.00 | $383.84 – $395.13 | 4 |
| Head CT scan (with and without contrast) CPT 70470 | $1,383.50 | $2,767.00 | $174.56 – $179.69 | 4 |
| Head CT scan (with contrast) CPT 70460 | $1,124.50 | $2,249.00 | $174.56 – $179.69 | 4 |
| Head CT scan (without contrast) CPT 70450 | $845.50 | $1,691.00 | $104.04 – $107.10 | 4 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $693.16 – $815.48 | 5 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,657.50 – $1,950.00 | 5 |
| Heart first pass multiple CPT 78483 | not published | not published | $540.36 – $556.26 | 4 |
| Heart image spect CPT 78494 | not published | not published | $397.85 – $409.55 | 4 |
| Heart infarct image CPT 78466 | not published | not published | $397.85 – $409.55 | 4 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $540.36 – $556.26 | 4 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Heavy metal qual any number CPT 83015 | $86.00 | $172.00 | $21.36 – $31.57 | 5 |
| Heinz bodies direct CPT 85441 | $23.00 | $46.00 | $4.28 – $7.06 | 5 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.96 – $11.42 | 5 |
| Helicobacter pylori antibody igm CPT 86677 | $65.00 | $130.00 | $17.19 – $24.34 | 5 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.35 – $13.73 | 5 |
| Hematocrit CPT 85014 | $12.50 | $25.00 | $2.42 – $3.97 | 5 |
| Hematopoietic nuclear tx CPT 79403 | $700.00 | $1,400.00 | not published | 0 |
| Hemicrt intrclry algrft prtl CPT 20933 | not published | not published | $511.00 – $2,004.00 | 2 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $3,256.29 – $10,995.00 | 6 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | not published | not published | $31.88 – $35.89 | 4 |
| Hemodialysis access study CPT 90940 | $659.00 | $1,318.00 | not published | 0 |
| Hemodialysis one evaluation CPT 90935 | not published | not published | $683.02 – $703.11 | 4 |
| Hemoglobin CPT 85018 | $12.50 | $25.00 | $2.42 – $3.97 | 5 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $3.96 – $4.21 | 5 |
| Hemoglobin fetal qualitative CPT 83033 | $41.00 | $82.00 | $8.16 – $10.00 | 5 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $10.95 – $13.87 | 5 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $34.50 | $69.00 | $8.36 – $12.28 | 5 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $13.61 – $16.75 | 5 |
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.