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 |
|---|---|---|---|---|
| Intro cath dialysis circuit w/pta CPT 36902 | $7,755.00 | $15,510.00 | $5,664.24 – $13,397.00 | 5 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $15,671.00 | $31,342.00 | $5,980.00 – $29,725.00 | 5 |
| Intro catheter aorta CPT 36200 | $2,476.50 | $4,953.00 | $511.00 – $2,670.00 | 2 |
| Intro cath svc/ivc CPT 36010 | $153.00 | $306.00 | $511.00 – $2,004.00 | 2 |
| Intro long gi tube CPT 44500 | $1,392.00 | $2,784.00 | $902.63 – $3,276.00 | 6 |
| Intro long gi tube w/mult fluo CPT 74340 | $465.50 | $931.00 | not published | 0 |
| Intro windpipe wire/tube CPT 31730 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $832.00 | $1,664.00 | $511.00 – $2,004.00 | 2 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $832.00 | $1,664.00 | $511.00 – $2,004.00 | 2 |
| Intubation endotracheal emergency procedure CPT 31500 | $881.00 | $1,762.00 | $235.71 – $1,010.00 | 6 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $58.71 – $60.44 | 4 |
| Iodine i-131 iobenguane 1mci HCPCS A9590 | not published | not published | $326.80 – $326.80 | 1 |
| Io ga n-stim subsq w/reprog CPT 95982 | not published | not published | $37.14 – $38.23 | 4 |
| Ionm in operatng room 15 min CPT 95940 | $83.00 | $166.00 | not published | 0 |
| Ionm remote/>1 pt or per hr CPT 95941 | $317.50 | $635.00 | not published | 0 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $4.00 | $8.00 | not published | 0 |
| Io rad tx deliver by elctrns CPT 77425 | not published | not published | $7,329.93 – $7,545.51 | 4 |
| Io rad tx delivery by x-ray CPT 77424 | $4,492.50 | $8,985.00 | $7,329.93 – $7,545.51 | 4 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | not published | not published | $187.15 – $192.65 | 4 |
| Ipratropium bromide comp HCPCS J7645 | not published | not published | $0.13 – $0.13 | 1 |
| Ipratropium bromide non-comp HCPCS J7644 | not published | not published | $1.03 – $1.03 | 1 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | not published | not published | $5.49 – $5.49 | 1 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | not published | not published | $67.32 – $69.30 | 4 |
| Iron CPT 83540 | $31.50 | $63.00 | $6.60 – $10.86 | 5 |
| Iron binding capacity CPT 83550 | $39.00 | $78.00 | $8.91 – $14.65 | 5 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | not published | not published | $18.47 – $19.01 | 4 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $7.02 – $10.85 | 5 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | not published | not published | $0.64 – $0.64 | 1 |
| Irradiation of blood product each unit reference CPT 86945 | $389.50 | $779.00 | $24.52 – $38.26 | 5 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $97.00 | $194.00 | $58.71 – $60.44 | 4 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $1,010.00 – $3,276.00 | 6 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $58.71 – $2,845.00 | 6 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $83.54 – $86.00 | 4 |
| Island pedicle flap graft CPT 15740 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Ivc venogram s&i CPT 75825 | $3,421.50 | $6,843.00 | $3,142.32 – $3,234.74 | 4 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $402.75 – $402.75 | 1 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $187.50 | $375.00 | $71.65 – $73.76 | 4 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $111.00 | $222.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $102.00 | $204.00 | $46.60 – $47.97 | 4 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $348.50 | $697.00 | $211.68 – $217.91 | 4 |
| IV inj ra drug dx study CPT 78808 | $197.50 | $395.00 | $397.85 – $409.55 | 4 |
| IV njx tst vasc flo flap/grf CPT 15860 | $845.50 | $1,691.00 | $444.58 – $2,845.00 | 6 |
| Ivp w/nephrotomography CPT 74415 | $662.00 | $1,324.00 | $174.56 – $179.69 | 4 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $531.50 | $1,063.00 | $174.56 – $179.69 | 4 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $142.00 – $146.17 | 4 |
| Jak2 targeted sequence analysis CPT 81279 | $824.50 | $1,649.00 | $188.90 – $222.24 | 5 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Jejunstmy tube plcmt CPT 44372 | $1,999.50 | $3,999.00 | $1,571.00 – $3,276.00 | 6 |
| John cunningham antibody CPT 86711 | $172.50 | $345.00 | $17.23 – $23.75 | 5 |
| J-tube placement CPT 44015 | $2,172.00 | $4,344.00 | $1,547.00 – $1,547.00 | 1 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | $944.96 | $1,889.91 | not published | 0 |
| Kafo femoral fx cast rigid HCPCS L2136 | $980.66 | $1,961.33 | not published | 0 |
| Keratomileusis CPT 65760 | not published | not published | $2,845.00 – $5,980.00 | 3 |
| Keratophakia CPT 65765 | not published | not published | $2,845.00 – $5,980.00 | 3 |
| Keratoprosthesis CPT 65770 | not published | not published | $5,980.00 – $14,825.67 | 5 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $0.03 – $29.64 | 2 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $15.78 – $23.76 | 5 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $36.00 | $72.00 | $8.33 – $13.70 | 5 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | not published | not published | $0.31 – $0.32 | 4 |
| Kidney endoscopy CPT 50551 | not published | not published | $1,010.00 – $5,479.92 | 6 |
| Kidney endoscopy CPT 50553 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Kidney endoscopy CPT 50570 | not published | not published | $1,010.00 – $3,602.64 | 6 |
| Kidney endoscopy CPT 50575 | not published | not published | $5,336.05 – $10,995.00 | 5 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $1,010.00 – $9,675.01 | 6 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $1,010.00 – $3,602.64 | 6 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $1,010.00 – $9,675.01 | 6 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $2,004.00 – $9,675.01 | 5 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $2,004.00 – $5,479.92 | 5 |
| Kidney function study CPT 78725 | not published | not published | $397.85 – $409.55 | 4 |
| Kidney imaging morphology CPT 78700 | $489.50 | $979.00 | $397.85 – $409.55 | 4 |
| Kidney imag w/bld flow multi CPT 78709 | $717.50 | $1,435.00 | $540.36 – $556.26 | 4 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $512.50 | $1,025.00 | $540.36 – $556.26 | 4 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $500.00 | $1,000.00 | $104.04 – $107.10 | 4 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $95.74 | $191.48 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $5,875.00 | $11,750.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $422.00 | $844.00 | $127.37 – $149.84 | 5 |
| Kit lead specify 5-6-5 HCPCS C1778 | $3,659.24 | $7,318.49 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $884.00 | $1,768.00 | not published | 0 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $1,600.27 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $1,600.27 – $10,995.00 | 6 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Knee cap medial or lateral p HCPCS L2800 | $104.54 | $209.07 | not published | 0 |
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.