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 |
|---|---|---|---|---|
| Hlth bhv ivntj fam 1st 30 CPT 96167 | $34.00 | $68.00 | not published | 0 |
| Hlth bhv ivntj grp 1st 30 CPT 96164 | $34.00 | $68.00 | not published | 0 |
| Hlth bhv ivntj indiv 1st 30 CPT 96158 | $96.50 | $193.00 | not published | 0 |
| Ho flex pavlik harns pre cst HCPCS L1620 | $89.53 | $179.06 | not published | 0 |
| Home sleep test/type 2 porta HCPCS G0398 | not published | not published | $214.89 – $221.21 | 4 |
| Home sleep test/type 3 porta HCPCS G0399 | not published | not published | $214.89 – $221.21 | 4 |
| Home sleep test/type 4 porta HCPCS G0400 | not published | not published | $214.89 – $221.21 | 4 |
| Homocysteine CPT 83090 | $74.00 | $148.00 | $18.28 – $28.28 | 5 |
| Homogenization tissue CPT 87176 | not published | not published | $6.00 – $9.86 | 5 |
| Homovanillic acid (hva) CPT 83150 | $88.50 | $177.00 | $22.86 – $32.45 | 5 |
| Ho post-op hip abduction HCPCS L1686 | $871.99 | $1,743.98 | not published | 0 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $124.66 – $181.07 | 5 |
| Hpa-1 genotyping CPT 81105 | $245.50 | $491.00 | $124.66 – $181.07 | 5 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $124.66 – $181.07 | 5 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $124.66 – $181.07 | 5 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $124.66 – $181.07 | 5 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $124.66 – $181.07 | 5 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $124.66 – $181.07 | 5 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $124.66 – $181.07 | 5 |
| Hpv combo assay ca screen HCPCS G0476 | not published | not published | $35.79 – $57.77 | 5 |
| Hpv low-risk types CPT 87623 | not published | not published | $35.79 – $57.31 | 5 |
| Hpv types 16 & 18 only CPT 87625 | $49.50 | $99.00 | $41.36 – $57.31 | 5 |
| H pylori ag ia CPT 87339 | not published | not published | $16.32 – $20.11 | 5 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $68.71 – $112.93 | 5 |
| H pylori (c-13) breath CPT 83013 | $281.50 | $563.00 | $68.71 – $112.93 | 5 |
| H pylori drug admin CPT 83014 | $17.50 | $35.00 | $8.02 – $13.18 | 5 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | $2,956.50 | $5,913.00 | $1,117.78 – $1,369.15 | 5 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | not published | not published | $722.52 – $829.58 | 2 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $596.60 – $962.80 | 5 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $596.60 – $866.52 | 5 |
| Hrv skn cll ssp agrft 1st 25 CPT 15011 | not published | not published | $2,053.37 – $3,276.00 | 5 |
| Hsv dna dir probe CPT 87528 | not published | not published | $20.45 – $33.62 | 5 |
| Htt gene charac alleles CPT 81274 | not published | not published | $280.33 – $329.80 | 5 |
| Htt gene detc abnor alleles CPT 81271 | $250.50 | $501.00 | $139.74 – $164.40 | 5 |
| Human epididymis protein 4 (he4) CPT 86305 | $88.50 | $177.00 | $21.23 – $35.77 | 5 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | not published | not published | $1.58 – $1.62 | 4 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $83.66 – $83.66 | 1 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $1.35 – $1.35 | 1 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | not published | not published | $1.01 – $1.01 | 1 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | not published | not published | $11.34 – $11.34 | 1 |
| Hydration IV infusion each additional hour CPT 96361 | $107.00 | $214.00 | $46.60 – $47.97 | 4 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $402.50 | $805.00 | $211.68 – $217.91 | 4 |
| Hydrocolld drg >16<=48 w/bdr HCPCS A6238 | $4.66 | $9.32 | not published | 0 |
| Hydrocolld drg >16<=48 without b HCPCS A6235 | $9.42 | $18.85 | not published | 0 |
| Hydrocolld drg <=16 in w/bdr HCPCS A6237 | $5.70 | $11.39 | not published | 0 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | $5.18 | $10.35 | not published | 0 |
| Hydrocortisone acetate inj HCPCS J1700 | not published | not published | $2.92 – $2.92 | 1 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | not published | not published | $58.27 – $58.27 | 1 |
| Hydrocortisone sodium ph inj HCPCS J1710 | not published | not published | $13.20 – $13.20 | 1 |
| Hydrogel drg <= 16 in w/bdr HCPCS A6245 | $6.73 | $13.46 | not published | 0 |
| Hydrogel drsg gel filler HCPCS A6248 | $18.12 | $36.23 | not published | 0 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.02 – $0.02 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | not published | not published | $34.26 – $34.26 | 1 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $80.50 | $161.00 | $18.26 – $29.36 | 5 |
| Hymenotomy CPT 56442 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $17.97 – $18.50 | 4 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $1,010.00 – $6,050.24 | 6 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $145.96 – $145.96 | 1 |
| #hypersens-actinomyces ab CPT 86602 | $46.50 | $93.00 | $10.38 – $17.06 | 5 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $383.84 – $395.13 | 4 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $549.89 – $566.06 | 4 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $549.89 – $566.06 | 4 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $549.89 – $566.06 | 4 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $18.51 – $19.06 | 4 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $8,246.00 – $8,246.00 | 1 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $8,246.00 – $8,246.00 | 1 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $1,547.00 – $5,980.00 | 2 |
| Hysterosalpingography s&i CPT 74740 | $219.50 | $439.00 | $237.46 – $244.44 | 4 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $4,007.00 – $8,246.00 | 6 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $3,221.58 – $5,978.00 | 6 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $3,221.58 – $5,978.00 | 6 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $3,895.00 – $5,978.00 | 6 |
| I-123 iobenguane diag HCPCS A9582 | $2,022.50 | $4,045.00 | $2,363.85 – $2,433.38 | 4 |
| I-123 ioflupane diag HCPCS A9584 | $2,137.00 | $4,274.00 | $1,415.49 – $1,457.13 | 4 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $78.50 | $157.00 | not published | 0 |
| I131 iodide cap, rx HCPCS A9517 | $41.50 | $83.00 | $24.55 – $25.27 | 4 |
| I131 iodide sol, rx HCPCS A9530 | $18.50 | $37.00 | $21.19 – $21.81 | 4 |
| Iaadi respiratory synctial virus CPT 87280 | not published | not published | $13.69 – $20.11 | 5 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $167.00 | $334.00 | $35.79 – $58.85 | 5 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $90.50 | $181.00 | $18.45 – $21.71 | 5 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $23.00 | $46.00 | $46.19 – $54.34 | 5 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $70.57 – $82.56 | 2 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,497.53 – $2,938.27 | 5 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $8.24 – $8.24 | 1 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $175.75 – $180.92 | 4 |
| Icatibant injection HCPCS J1744 | not published | not published | $71.33 – $251.91 | 3 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $20,608.40 | $41,216.81 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $20,608.40 | $41,216.81 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $9,880.63 | $19,761.26 | not published | 0 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $5,681.12 | $11,362.23 | not published | 0 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $214.89 – $221.21 | 4 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $37.17 – $38.26 | 4 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $58.71 – $60.44 | 4 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | $2,721.00 | $5,442.00 | $1,010.00 – $3,388.50 | 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.