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 |
|---|---|---|---|---|
| Incision of lymph channels CPT 38308 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of metatarsal CPT 28306 | not published | not published | $3,338.00 – $7,416.07 | 6 |
| Incision of metatarsal CPT 28307 | not published | not published | $3,338.00 – $7,416.07 | 6 |
| Incision of metatarsal CPT 28308 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of metatarsals CPT 28309 | not published | not published | $3,338.00 – $13,397.00 | 6 |
| Incision of midfoot bones CPT 28304 | not published | not published | $1,571.00 – $13,397.00 | 6 |
| Incision of neck of femur CPT 27161 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision of palm tendon CPT 26450 | not published | not published | $3,256.29 – $3,895.00 | 6 |
| Incision of prostate CPT 52450 | not published | not published | $3,304.00 – $5,978.00 | 6 |
| Incision of pyloric muscle 43520 CPT 43520 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of rectal abscess CPT 46060 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Incision of small bowel 44010 CPT 44010 | not published | not published | $1,547.00 – $4,339.00 | 2 |
| Incision of sperm duct CPT 55200 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of spinal nerve 64772 CPT 64772 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of stomach nerves CPT 64755 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of tendon & muscle CPT 23405 | $3,805.00 | $7,610.00 | $1,571.00 – $8,246.00 | 6 |
| Incision of tendon sheath CPT 25000 | not published | not published | $1,600.27 – $5,978.00 | 6 |
| Incision of thigh CPT 27448 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision of thigh CPT 27450 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incision of thigh tendon CPT 27306 | $2,860.00 | $5,720.00 | $3,256.29 – $5,978.00 | 6 |
| Incision of thigh tendon CPT 27390 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incision of thigh tendons CPT 27307 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Incision of thigh tendons CPT 27391 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of thigh tendons CPT 27392 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Incision of tibia CPT 27705 | not published | not published | $1,571.00 – $10,995.00 | 6 |
| Incision of tibia & fibula CPT 27709 | not published | not published | $1,571.00 – $13,121.51 | 6 |
| Incision of toe tendons 28011 CPT 28011 | not published | not published | $1,600.27 – $5,978.00 | 6 |
| Incision of tongue fold CPT 41010 | $710.50 | $1,421.00 | $1,010.00 – $3,276.00 | 6 |
| Incision of tongue nerve CPT 64740 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incision of urethra CPT 53000 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incision of urethra CPT 53010 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incision of urethra CPT 53020 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Incision of urethra CPT 53025 | not published | not published | $2,004.00 – $5,978.00 | 5 |
| Incision of vagus nerve CPT 64760 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Incision of windpipe CPT 31601 | not published | not published | $5,891.41 – $6,064.68 | 5 |
| Incision of windpipe CPT 31610 | not published | not published | $5,891.41 – $6,064.68 | 5 |
| Incision of wrist capsule CPT 25085 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Incision secondary cataract CPT 66820 | not published | not published | $511.00 – $2,358.66 | 6 |
| Incision tendon sheath CPT 26055 | $1,010.50 | $2,021.00 | $1,571.00 – $3,276.00 | 6 |
| Incisn of toe tndn CPT 28010 | $2,369.50 | $4,739.00 | $1,600.27 – $5,978.00 | 5 |
| Incisn windpipe CPT 31600 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Incis spine 3 column adl seg CPT 22208 | not published | not published | $511.00 – $2,004.00 | 2 |
| Incis spine 3 column lumbar CPT 22207 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incis spine 3 column thorac CPT 22206 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Incobotulinumtoxin a HCPCS J0588 | not published | not published | $5.47 – $5.85 | 4 |
| Inc&subq plmt crnl bone grf CPT 61316 | not published | not published | $1,547.00 – $2,004.00 | 2 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | not published | not published | $10.16 – $10.45 | 4 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $2,670.00 – $3,276.00 | 2 |
| Induced ab 1+vag supp hyst CPT 59857 | not published | not published | $1,547.00 – $2,670.00 | 2 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | $1,565.50 | $3,131.00 | $1,547.00 – $1,547.00 | 1 |
| Induced abortion 1+njx d&c CPT 59851 | not published | not published | $1,547.00 – $2,670.00 | 3 |
| Induced abortion 1+njx hyst CPT 59852 | not published | not published | $1,547.00 – $2,670.00 | 2 |
| Induced abortion d&c CPT 59840 | not published | not published | $3,221.58 – $5,978.00 | 6 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $3,221.58 – $5,978.00 | 6 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $71.60 – $73.71 | 4 |
| Infec agen detec ampli probe HCPCS U0005 | $12.50 | $25.00 | not published | 0 |
| Infect ag drug suscept pheno predict CPT 87900 | $662.00 | $1,324.00 | $132.96 – $218.53 | 5 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $15.30 – $20.11 | 5 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $14.41 – $20.11 | 5 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $262.60 – $424.66 | 5 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $262.60 – $424.66 | 5 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $530.00 | $1,060.00 | $131.30 – $217.37 | 5 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,154.50 | $2,309.00 | $262.60 – $431.63 | 5 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $96.50 | $193.00 | $33.43 – $39.32 | 5 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $20.11 – $37.05 | 5 |
| Infect ag ia optc obs influenza CPT 87804 | $62.00 | $124.00 | $16.88 – $20.11 | 5 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $31.50 | $63.00 | $12.22 – $20.11 | 5 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $18.73 – $27.53 | 5 |
| Infect ag if influenza a CPT 87276 | not published | not published | $16.39 – $20.11 | 5 |
| Infect ag if influenza b CPT 87275 | not published | not published | $12.50 – $20.11 | 5 |
| Infect ag if legionella pneumophila CPT 87278 | $61.00 | $122.00 | $15.91 – $20.11 | 5 |
| Infect ag if nos ea CPT 87299 | not published | not published | $16.42 – $20.11 | 5 |
| Infect ag if pneumocystis carinii CPT 87281 | not published | not published | $12.22 – $20.11 | 5 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $13.69 – $20.11 | 5 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $54.54 – $58.61 | 5 |
| Infect ag na hep b amp CPT 87516 | $120.50 | $241.00 | $35.79 – $58.85 | 5 |
| Infect ag na herpes simplex quant CPT 87530 | $167.00 | $334.00 | $43.70 – $71.82 | 5 |
| Infect ag na hpv high-risk types CPT 87624 | $49.50 | $99.00 | $35.79 – $57.31 | 5 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $247.00 | $494.00 | $97.72 – $143.70 | 5 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $52.34 – $86.66 | 5 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $38.50 | $77.00 | $52.34 – $61.40 | 5 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $258.00 | $516.00 | $425.12 – $687.49 | 5 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $2,471.50 | $4,943.00 | $498.43 – $819.26 | 5 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $135.00 | $270.00 | $26.59 – $218.53 | 5 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $42.21 – $49.82 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $10.50 | $21.00 | $12.22 – $20.11 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $61.50 | $123.00 | $13.69 – $20.11 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $29.50 | $59.00 | $14.10 – $20.11 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $61.50 | $123.00 | $12.22 – $20.11 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $186.50 | $373.00 | $14.67 – $24.12 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $52.00 | $104.00 | $10.54 – $17.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | not published | not published | $10.54 – $17.32 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | not published | not published | $24.56 – $40.94 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $61.50 | $123.00 | $12.22 – $20.11 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $58.50 | $117.00 | $12.22 – $20.11 | 5 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $58.50 | $117.00 | $12.22 – $20.11 | 5 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $167.00 | $334.00 | $35.79 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $167.00 | $334.00 | $35.79 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $35.00 | $70.00 | $38.02 – $60.32 | 5 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $463.50 | $927.00 | $425.12 – $686.06 | 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.