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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $167.00 | $334.00 | $35.79 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $145.00 | $290.00 | $35.79 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $138.50 | $277.00 | $42.51 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $167.00 | $334.00 | $35.79 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $54.00 | $108.00 | $52.34 – $61.57 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $125.00 | $250.00 | $145.48 – $171.25 | 5 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $150.00 | $300.00 | $145.48 – $171.25 | 5 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $45.50 | $91.00 | $35.79 – $58.85 | 5 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $135.50 | $271.00 | $35.79 – $57.44 | 5 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $71.58 – $73.69 | 4 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $78.31 – $80.61 | 4 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $693.37 – $713.76 | 4 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $350.00 | $700.00 | $425.12 – $680.62 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $130.86 – $209.50 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $116.50 | $233.00 | $268.25 – $348.54 | 5 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $176.00 | $352.00 | $43.70 – $71.82 | 5 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $159.50 | $319.00 | $43.70 – $71.82 | 5 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $167.00 | $334.00 | $43.70 – $71.82 | 5 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $349.50 | $699.00 | $86.80 – $142.67 | 5 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | not published | not published | $145.48 – $211.61 | 5 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $31.71 – $32.64 | 4 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $20.81 – $21.43 | 4 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $20.39 – $20.99 | 4 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $29.80 – $35.06 | 5 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $157.80 – $157.80 | 1 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $54.56 – $54.56 | 1 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $511.00 – $2,004.00 | 2 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $511.00 – $2,004.00 | 2 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $511.00 – $2,004.00 | 2 |
| Infuse radioactive materials CPT 77750 | $303.00 | $606.00 | $383.84 – $395.13 | 4 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $371.37 – $382.29 | 4 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $99.50 | $199.00 | $217.93 – $224.34 | 4 |
| Initial foot exam pt lops HCPCS G0245 | $155.50 | $311.00 | $132.50 – $136.39 | 4 |
| Initiation & management bipap/cpap initial day CPT 94660 | $251.50 | $503.00 | $217.93 – $224.34 | 4 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $6.15 – $6.33 | 4 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $7.42 – $7.64 | 4 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.04 – $0.04 | 4 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.13 – $0.13 | 1 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.11 – $0.11 | 1 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $173.37 – $173.37 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $20.11 – $20.11 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $61,200.00 – $66,509.40 | 4 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $11.30 – $16.64 | 2 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $34.51 – $37.37 | 4 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $799.20 – $902.33 | 4 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $317.61 – $326.95 | 4 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.60 – $1.65 | 4 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $4.82 – $4.96 | 4 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $132.84 – $136.75 | 4 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $38.57 – $39.71 | 4 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.81 – $10.09 | 4 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $134.00 – $137.94 | 4 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $18.14 – $18.98 | 4 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $1.95 – $2.01 | 4 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.31 – $3.41 | 4 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $52.87 – $54.42 | 4 |
| Inj. asceniv HCPCS J1554 | not published | not published | $465.66 – $521.58 | 4 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $56.58 – $58.25 | 4 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $32.22 – $33.16 | 4 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $107.10 – $110.38 | 4 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $82.53 – $84.96 | 4 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $119.30 – $119.30 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $167.88 – $172.82 | 4 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $0.02 – $3,093,027.00 | 4 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $38.76 – $41.82 | 4 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $206.55 – $224.53 | 4 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $26.67 – $27.46 | 4 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $3.53 – $3.63 | 4 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $7.11 – $7.32 | 4 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $4.03 – $4.03 | 1 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $75.99 – $201.37 | 2 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $429.05 – $441.67 | 4 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,716.20 – $1,766.67 | 4 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $347.23 – $363.41 | 4 |
| Inj bulking agent anal canal HCPCS L8605 | $851.29 | $1,702.58 | not published | 0 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.50 – $1.54 | 4 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.96 – $0.96 | 1 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $63.03 – $64.89 | 4 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $2.68 – $2.68 | 1 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $264.89 – $272.68 | 4 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $3.42 – $3.42 | 1 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $1.72 – $1.72 | 1 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $1.89 – $1.89 | 1 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $15.95 – $15.95 | 1 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $13.70 – $13.70 | 1 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.37 – $2.54 | 4 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $9.25 – $9.52 | 4 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $119.58 – $126.38 | 4 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $16.85 – $17.34 | 4 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $87.88 – $90.46 | 4 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $88.85 – $95.77 | 4 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $5.44 – $5.44 | 1 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $83.50 | $167.00 | $511.00 – $2,004.00 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $236.67 – $236.67 | 1 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,066.05 – $1,097.41 | 4 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $518.21 – $579.09 | 4 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $14.52 – $14.94 | 4 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $17.18 – $17.68 | 4 |
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.