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 |
|---|---|---|---|---|
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $9.29 – $9.56 | 4 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.64 – $0.66 | 4 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.80 – $0.82 | 4 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $4.01 – $4.13 | 4 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.11 – $0.11 | 1 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.08 – $0.08 | 1 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $3.21 – $3.31 | 4 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $5.41 – $5.41 | 1 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $0.02 – $3,482,285.72 | 4 |
| Inj. denosumab-bbdz, 1 mg HCPCS Q5136 | not published | not published | $28.09 – $28.91 | 4 |
| Inj diclofenac sodium 0.5mg HCPCS J1130 | not published | not published | $0.56 – $0.56 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | $1,768.00 | $3,536.00 | $511.00 – $2,004.00 | 2 |
| Inj, docetaxel (beizray) 1mg HCPCS J9174 | not published | not published | $53.52 – $55.09 | 4 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.05 – $4.34 | 4 |
| Inj dupuytren cord w/enzyme CPT 20527 | $155.00 | $310.00 | $305.48 – $2,845.00 | 6 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $6.91 – $7.11 | 4 |
| Inj dx for sinogram CPT 20501 | $232.00 | $464.00 | $511.00 – $2,004.00 | 2 |
| Inject for sacroiliac joint HCPCS G0259 | $428.00 | $856.00 | $511.00 – $2,004.00 | 2 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,084.00 | $2,168.00 | $702.49 – $1,547.00 | 5 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $323.00 | $646.00 | $511.00 – $2,004.00 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $51.11 – $55.10 | 4 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $462.17 – $508.34 | 4 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $20.38 – $20.98 | 4 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $282.50 | $565.00 | $305.48 – $1,010.00 | 6 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $169.38 – $174.36 | 4 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $72.80 – $74.94 | 4 |
| Injection, doxercalciferol HCPCS J1270 | not published | not published | $1.06 – $1.06 | 1 |
| Injection during cath supravalvular aortography CPT 93567 | $197.50 | $395.00 | $511.00 – $511.00 | 1 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $17.22 – $22.04 | 4 |
| Injection epidural blood patch or clot CPT 62273 | $705.00 | $1,410.00 | $702.49 – $1,547.00 | 6 |
| Injection estrone per 1 mg HCPCS J1435 | not published | not published | $0.45 – $0.45 | 1 |
| Injection eye drug CPT 67028 | $807.00 | $1,614.00 | $328.72 – $1,010.00 | 6 |
| Injection for arthrography wrist (both sides) CPT 25246 | $358.00 | $716.00 | $511.00 – $2,004.00 | 2 |
| Injection for bladder x-ray CPT 51600 | $694.50 | $1,389.00 | $511.00 – $511.00 | 1 |
| Injection for hip x-ray CPT 27095 | $208.00 | $416.00 | $511.00 – $2,004.00 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $250.50 | $501.00 | $511.00 – $2,004.00 | 2 |
| Injection for spleen x-ray CPT 38200 | $2,359.50 | $4,719.00 | $511.00 – $2,004.00 | 2 |
| Injection for tear sac x-ray CPT 68850 | $977.00 | $1,954.00 | $511.00 – $2,004.00 | 2 |
| Injection for ureter x-ray CPT 50684 | $1,789.50 | $3,579.00 | $511.00 – $2,004.00 | 2 |
| Injection for ureter x-ray CPT 50690 | $1,320.00 | $2,640.00 | $511.00 – $2,004.00 | 2 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $13.19 – $18.52 | 2 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $155.42 – $303.14 | 2 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $12.39 – $12.93 | 4 |
| Injection into brain canal CPT 61026 | not published | not published | $702.49 – $1,547.00 | 6 |
| Injection into brain canal CPT 61055 | $825.50 | $1,651.00 | $305.48 – $1,010.00 | 6 |
| Injection into hemorrhoid(s) CPT 46500 | $1,339.50 | $2,679.00 | $925.49 – $1,547.00 | 5 |
| Injection into spinal artery CPT 62294 | not published | not published | $880.23 – $3,895.00 | 6 |
| Injection into vocal cord CPT 31513 | not published | not published | $389.24 – $1,571.00 | 6 |
| Injection intraop add-on CPT 48400 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $1.03 – $1.06 | 4 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $511.00 – $2,004.00 | 2 |
| Injection jugular CPT 36299 | not published | not published | $511.00 – $511.00 | 1 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $3.76 – $3.76 | 1 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.85 – $6.02 | 4 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $71.65 – $73.76 | 4 |
| Injection of sinus tract CPT 20500 | $1,128.00 | $2,256.00 | $1,544.13 – $3,276.00 | 6 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $6.56 – $6.82 | 4 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.71 – $1.76 | 4 |
| Injection px peyronie ds CPT 54200 | not published | not published | $248.65 – $1,010.00 | 6 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $425.00 | $850.00 | $397.85 – $1,010.00 | 6 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $27.54 – $28.35 | 4 |
| Injection, ruconest HCPCS J0596 | not published | not published | $37.50 – $38.60 | 4 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,231.00 | $2,462.00 | $702.49 – $1,547.00 | 6 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $357.00 | $714.00 | $702.49 – $1,547.00 | 6 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $602.00 | $1,204.00 | $702.49 – $1,547.00 | 6 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $779.00 | $1,558.00 | $880.23 – $1,547.00 | 6 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $667.50 | $1,335.00 | $511.00 – $2,004.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,331.00 | $2,662.00 | $880.23 – $1,547.00 | 6 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $667.50 | $1,335.00 | $511.00 – $2,004.00 | 2 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,160.00 | $2,320.00 | $880.23 – $1,547.00 | 6 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,144.50 | $2,289.00 | $702.49 – $1,547.00 | 6 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,157.50 | $2,315.00 | $702.49 – $1,547.00 | 6 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $162.32 – $174.12 | 4 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $399.50 | $799.00 | $305.48 – $1,010.00 | 6 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $234.00 | $468.00 | $305.48 – $1,010.00 | 6 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $245.50 | $491.00 | $305.48 – $1,010.00 | 6 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $120.00 | $240.00 | $46.60 – $47.97 | 4 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $138.50 | $277.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $228.50 | $457.00 | $211.68 – $217.91 | 4 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $75.00 | $150.00 | $71.65 – $73.76 | 4 |
| Injection treatment of eye CPT 66020 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Injection treatment of eye CPT 66030 | $1,556.50 | $3,113.00 | $1,010.00 – $3,276.00 | 6 |
| Injection treatment of nerve CPT 64605 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Injection treatment of nerve CPT 64610 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Injection treatment of nerve CPT 64681 | not published | not published | $880.23 – $1,571.00 | 6 |
| Injection treatment of nose CPT 30200 | not published | not published | $511.00 – $1,010.00 | 6 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $511.00 – $2,845.00 | 3 |
| Inject/treat eye socket CPT 67500 | not published | not published | $315.88 – $2,845.00 | 6 |
| Inject/treat eye socket CPT 67505 | not published | not published | $315.88 – $1,010.00 | 6 |
| Inject/treat eye socket CPT 67515 | not published | not published | $315.88 – $1,010.00 | 6 |
| Inj, eculizumab-aagh, 2 mg HCPCS Q5151 | not published | not published | $31.98 – $32.92 | 4 |
| Inj, eculizumab-aeeb, 2 mg HCPCS Q5152 | not published | not published | $41.12 – $42.33 | 4 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $32.56 – $35.58 | 4 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $21.29 – $21.92 | 4 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $370.42 – $404.09 | 4 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $57.22 – $58.91 | 4 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,122.00 | $2,244.00 | $702.49 – $1,547.00 | 6 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,144.50 | $2,289.00 | $880.23 – $1,547.00 | 6 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $6.63 – $6.63 | 1 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.19 – $1.37 | 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.