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 |
|---|---|---|---|---|
| Impres&prep def obt prosth CPT 21080 | not published | not published | $3,299.54 – $10,995.00 | 5 |
| Impres&prep facial prosth CPT 21088 | not published | not published | $3,299.54 – $10,995.00 | 5 |
| Impres&prep intrm obt prosth CPT 21079 | not published | not published | $3,299.54 – $10,995.00 | 5 |
| Impres&prep mndbl res prosth CPT 21081 | not published | not published | $5,891.41 – $10,995.00 | 5 |
| Impres&prep nasal prosth CPT 21087 | not published | not published | $5,891.41 – $10,995.00 | 5 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $235.71 – $511.00 | 5 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $5,891.41 – $10,995.00 | 5 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $3,299.54 – $10,995.00 | 5 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $3,299.54 – $10,995.00 | 5 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $3,299.54 – $10,995.00 | 5 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $1,544.13 – $3,276.00 | 5 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $44.05 – $45.35 | 4 |
| In-111 autol wbc diag per dose HCPCS A9570 | $1,928.00 | $3,856.00 | $1,125.25 – $1,158.35 | 4 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $1,508.26 – $1,508.26 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | not published | not published | $848.09 – $873.03 | 4 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $1,340.00 | $2,680.00 | $760.53 – $782.90 | 4 |
| In-111 pentetreotide HCPCS A9572 | $3,584.00 | $7,168.00 | $2,040.96 – $2,100.99 | 4 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $3,256.29 – $10,995.00 | 5 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $1,571.00 – $7,416.07 | 6 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incis 1 vertebral seg thorac CPT 22212 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incis addl spine segment CPT 22216 | not published | not published | $511.00 – $2,004.00 | 2 |
| Incise bile duct sphincter CPT 47460 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $992.09 – $3,276.00 | 5 |
| Incise flexor carpi radialis CPT 25001 | not published | not published | $2,004.00 – $5,978.00 | 6 |
| Incise hand/finger tendon CPT 26460 | not published | not published | $1,600.27 – $3,895.00 | 6 |
| Incise hip/thigh nerve CPT 64763 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incise hip/thigh nerve CPT 64766 | not published | not published | $1,943.35 – $8,246.00 | 6 |
| Incise inner ear CPT 69801 | not published | not published | $1,544.13 – $4,441.00 | 6 |
| Incise inner ear nerve CPT 69915 | not published | not published | $3,299.54 – $10,995.00 | 6 |
| Incise inner ear nerve CPT 69950 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise inner eye adhesions CPT 65860 | not published | not published | $547.36 – $1,547.00 | 6 |
| Incise inner eye adhesions CPT 65865 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incise inner eye adhesions CPT 65870 | not published | not published | $2,296.74 – $5,978.00 | 6 |
| Incise inner eye adhesions CPT 65875 | not published | not published | $2,296.74 – $5,978.00 | 6 |
| Incise inner eye adhesions CPT 65880 | not published | not published | $3,338.00 – $5,978.00 | 6 |
| Incise inner eye strands CPT 67030 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incise nerve back of head CPT 64744 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incise perq finger tendon 26060 CPT 26060 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incise skull/brain surgery CPT 61720 | not published | not published | $8,733.71 – $10,995.00 | 5 |
| Incise skull/brain surgery CPT 61735 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise skull for treatment CPT 61770 | not published | not published | $3,399.75 – $10,995.00 | 6 |
| Incise skull repair CPT 62121 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise skull/sutures CPT 61556 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise skull/sutures CPT 61557 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise sperm duct pouch CPT 55600 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incise spinal cord tract(s) CPT 63170 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incise spine accessory nerve CPT 63191 | not published | not published | $29,725.00 – $29,725.00 | 1 |
| Incise spine nrv >2 segmnts CPT 63190 | not published | not published | $29,725.00 – $29,725.00 | 1 |
| Incise spine nrv half segmnt CPT 63185 | not published | not published | $29,725.00 – $29,725.00 | 1 |
| Incise tear duct opening 68440 CPT 68440 | not published | not published | $315.88 – $1,010.00 | 6 |
| Incise tendon(s) & muscle(s) CPT 23406 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Incise thigh tendon & fascia CPT 27305 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incise & treat bladder CPT 51030 | not published | not published | $4,314.00 – $4,314.00 | 1 |
| Incise wrist/forearm tendon CPT 25290 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Incision anal septum infant CPT 46070 | not published | not published | $2,004.00 – $3,276.00 | 5 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $1,757.00 | $3,514.00 | $1,643.67 – $3,276.00 | 6 |
| Incision & drainage open of deep abscess (subfascial) pos CPT 22010 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision/fixation of femur CPT 27165 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision of achilles tendon CPT 27605 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incision of achilles tendon CPT 27606 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incision of anal sphincter CPT 46080 | not published | not published | $2,762.33 – $3,895.00 | 6 |
| Incision of ankle bone CPT 28302 | not published | not published | $1,571.00 – $7,416.07 | 6 |
| Incision of bile duct CPT 47425 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of bile duct 47420 CPT 47420 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of brain tissue CPT 61541 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of brain tissue CPT 61567 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of breast lesion CPT 19020 | $1,757.00 | $3,514.00 | $1,571.00 – $5,978.00 | 6 |
| Incision of brow nerve CPT 64732 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incision of burn scab initi CPT 16035 | $339.50 | $679.00 | $404.56 – $511.00 | 5 |
| Incision of cheek nerve CPT 64734 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incision of chin nerve CPT 64736 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incision of eardrum CPT 69420 | not published | not published | $235.71 – $1,010.00 | 6 |
| Incision of eardrum CPT 69421 | not published | not published | $3,276.00 – $3,895.00 | 6 |
| Incision of esophagus CPT 43020 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Incision of eye CPT 65850 | not published | not published | $2,296.74 – $5,978.00 | 6 |
| Incision of eye CPT 66172 | not published | not published | $2,296.74 – $5,978.00 | 6 |
| Incision of eyelid CPT 67710 | not published | not published | $992.09 – $3,276.00 | 6 |
| Incision of facial nerve CPT 64742 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of fibula CPT 27707 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Incision of finger tendon CPT 26455 | not published | not published | $1,600.27 – $3,895.00 | 6 |
| Incision of foot fascia CPT 28008 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Incision of foot tendon 28234 CPT 28234 | $756.50 | $1,513.00 | $1,571.00 – $5,978.00 | 6 |
| Incision of gallbladder 47480 CPT 47480 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of heel bone CPT 28300 | not published | not published | $1,571.00 – $13,397.00 | 6 |
| Incision of hip bone CPT 27146 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision of hip bones CPT 27151 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision of hip tendon CPT 27000 | $2,723.50 | $5,447.00 | $1,571.00 – $5,978.00 | 6 |
| Incision of hip tendon CPT 27001 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Incision of hip tendon CPT 27003 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Incision of hip tendons CPT 27006 | not published | not published | $3,256.29 – $8,246.00 | 5 |
| Incision of iris CPT 66500 | not published | not published | $511.00 – $2,358.66 | 6 |
| Incision of iris CPT 66505 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Incision of jaw joint CPT 21010 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of jaw nerve CPT 64738 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incision of knee joint CPT 27435 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Incision of liver duct CPT 47400 | not published | not published | $1,547.00 – $1,547.00 | 1 |
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.