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 |
|---|---|---|---|---|
| Maxillofacial fixation CPT 21100 | not published | not published | $1,571.00 – $10,995.00 | 6 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $104.00 | $208.00 | $14.75 – $24.24 | 5 |
| Mayo aathr protein s free CPT 85306 | $37.50 | $75.00 | $15.63 – $25.69 | 5 |
| Mayo activated protein c resistance assay CPT 85307 | $76.00 | $152.00 | $15.63 – $25.69 | 5 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $62.00 | $124.00 | $39.34 – $46.28 | 5 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | not published | not published | $0.03 – $17.64 | 2 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | not published | not published | $0.03 – $28.22 | 2 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $68.00 | $136.00 | $15.08 – $24.79 | 5 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | not published | not published | $0.03 – $49.02 | 2 |
| Mayo alpha 1 antitrypsin CPT 82103 | $66.00 | $132.00 | $13.71 – $22.52 | 5 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $88.00 | $176.00 | $15.38 – $25.27 | 5 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $0.03 – $25.38 | 2 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $0.03 – $29.64 | 2 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $322.00 | $644.00 | $124.06 – $198.82 | 5 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $264.00 | $528.00 | $93.49 – $150.07 | 5 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $601.00 | $1,202.00 | $139.74 – $164.40 | 5 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $580.00 | $1,160.00 | $1,183.20 – $1,392.00 | 5 |
| Mayo androstenedione CPT 82157 | $130.50 | $261.00 | $29.87 – $49.08 | 5 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $74.00 | $148.00 | $14.89 – $24.47 | 5 |
| Mayo antithrombin iii antigen CPT 85301 | $21.50 | $43.00 | $11.03 – $18.13 | 5 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $66.50 | $133.00 | $15.35 – $25.24 | 5 |
| Mayo avwpr vw factor activity CPT 85397 | $111.00 | $222.00 | $31.48 – $40.21 | 5 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $167.00 | $334.00 | $35.79 – $42.11 | 5 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | not published | not published | $0.03 – $18.70 | 2 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $46.50 | $93.00 | $10.38 – $17.06 | 5 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $51.50 | $103.00 | $147.74 – $237.11 | 5 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | not published | not published | $218.91 – $263.32 | 5 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $58.00 | $116.00 | $13.16 – $21.64 | 5 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | not published | not published | $0.03 – $29.64 | 2 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $59.00 | $118.00 | $13.45 – $22.12 | 5 |
| Mayo brcmg brucella antibody igm CPT 86622 | $40.00 | $80.00 | $9.11 – $14.98 | 5 |
| Mayo c1 esterase inhibitor CPT 83883 | $63.50 | $127.00 | $13.87 – $22.80 | 5 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | not published | not published | $0.03 – $29.64 | 2 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $74.00 | $148.00 | $17.21 – $28.28 | 5 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $108.00 | $216.00 | $27.32 – $44.89 | 5 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $307.50 | $615.00 | $124.66 – $200.09 | 5 |
| Mayo ceruloplasmin CPT 82390 | $55.00 | $110.00 | $10.95 – $18.01 | 5 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $310.50 | $621.00 | $14.40 – $23.69 | 5 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $59.00 | $118.00 | $13.14 – $21.60 | 5 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $53.00 | $106.00 | $12.06 – $19.82 | 5 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $57.00 | $114.00 | $12.93 – $21.29 | 5 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $292.00 | $584.00 | $118.82 – $195.32 | 5 |
| Mayo chromium CPT 82495 | $93.50 | $187.00 | $20.69 – $34.01 | 5 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | not published | not published | $0.03 – $24.74 | 2 |
| Mayo coccidioides antibody CPT 86635 | $51.00 | $102.00 | $11.70 – $19.24 | 5 |
| Mayo cocou cortisone urine CPT 82542 | $464.00 | $928.00 | $24.57 – $30.28 | 5 |
| Mayo cortisol free CPT 82530 | $20.00 | $40.00 | $17.04 – $28.02 | 5 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $21.06 | $42.13 | $42.97 – $50.56 | 5 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $215.50 | $431.00 | $12.36 – $20.33 | 5 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | not published | not published | $0.03 – $32.33 | 2 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | not published | not published | $0.03 – $0.03 | 1 |
| Mayo cyanide CPT 82600 | $88.50 | $177.00 | $19.79 – $32.53 | 5 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $1,591.00 | $3,182.00 | $67.70 – $174.54 | 5 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $56.50 | $113.00 | $13.52 – $22.21 | 5 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $132.00 | $264.00 | $25.78 – $42.37 | 5 |
| Mayo dihydrotestosterone CPT 82642 | $128.00 | $256.00 | $29.87 – $39.04 | 5 |
| Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 | not published | not published | $9.83 – $14.22 | 5 |
| Mayo efpo chloride stool CPT 82438 | $23.00 | $46.00 | $5.10 – $8.20 | 5 |
| Mayo estriol CPT 82677 | $110.00 | $220.00 | $24.66 – $40.55 | 5 |
| Mayo estrone CPT 82679 | $109.00 | $218.00 | $25.45 – $41.86 | 5 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $93.00 | $186.00 | $16.67 – $27.40 | 5 |
| Mayo everolimus therapeutic drug level CPT 80169 | $75.50 | $151.00 | $14.00 – $22.48 | 5 |
| Mayo factor ii CPT 85210 | $22.50 | $45.00 | $13.24 – $21.77 | 5 |
| Mayo factor v CPT 85220 | $62.50 | $125.00 | $18.00 – $29.59 | 5 |
| Mayo factor vii CPT 85230 | $26.00 | $52.00 | $18.26 – $30.02 | 5 |
| Mayo factor viii vw factor antigen CPT 85246 | $22.50 | $45.00 | $23.40 – $38.47 | 5 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $112.50 | $225.00 | $23.40 – $38.47 | 5 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $112.50 | $225.00 | $23.40 – $38.47 | 5 |
| Mayo factor x CPT 85260 | $71.00 | $142.00 | $18.26 – $30.02 | 5 |
| Mayo factor xi CPT 85270 | $26.00 | $52.00 | $18.26 – $30.02 | 5 |
| Mayo fat/lipids feces quantitative CPT 82710 | $64.50 | $129.00 | $17.14 – $28.16 | 5 |
| Mayo fbl culture fungi blood CPT 87103 | $43.50 | $87.00 | $15.12 – $21.48 | 5 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $14.44 – $84.48 | 5 |
| Mayo ffspg allergen clam igg CPT 86001 | $26.00 | $52.00 | $7.98 – $8.76 | 5 |
| Mayo fibrinogen antigen CPT 85385 | $44.50 | $89.00 | $14.24 – $15.18 | 5 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $72.00 | $144.00 | $21.71 – $22.75 | 5 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $3,186.00 | $6,372.00 | not published | 0 |
| Mayo hemosiderin qualitative urine CPT 83070 | not published | not published | $4.84 – $7.97 | 5 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $120.50 | $241.00 | $35.79 – $58.85 | 5 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $36.00 | $72.00 | $35.79 – $58.85 | 5 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $56.00 | $112.00 | $14.07 – $20.95 | 5 |
| Mayo hla typing a/b/c single antigen CPT 86812 | not published | not published | $26.33 – $43.27 | 5 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $40.00 | $80.00 | $9.07 – $14.89 | 5 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $61.50 | $123.00 | $13.79 – $22.66 | 5 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $121.50 | $243.00 | $27.71 – $45.54 | 5 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $430.00 | $860.00 | $17.62 – $21.71 | 5 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $66.50 | $133.00 | $15.29 – $25.14 | 5 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $92.50 | $185.00 | $21.23 – $34.88 | 5 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $175.50 | $351.00 | $21.23 – $34.88 | 5 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $35.79 – $36.84 | 4 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $81.00 | $162.00 | $16.39 – $20.11 | 5 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $60.00 | $120.00 | $12.22 – $20.11 | 5 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $145.00 | $290.00 | $35.79 – $58.85 | 5 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $36.00 | $72.00 | $35.79 – $42.11 | 5 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | not published | not published | $35.79 – $58.85 | 5 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | not published | not published | $35.79 – $36.84 | 4 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $167.00 | $334.00 | $43.70 – $71.82 | 5 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $137.00 | $274.00 | $73.63 – $86.63 | 5 |
| Mayo infliximab therapeutic drug level CPT 80230 | $62.00 | $124.00 | $39.34 – $46.28 | 5 |
| Mayo inhab inhibin a CPT 86336 | $72.50 | $145.00 | $15.90 – $26.12 | 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.