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 |
|---|---|---|---|---|
| Mayo insft insulin free CPT 83527 | $60.00 | $120.00 | $13.21 – $21.71 | 5 |
| Mayo insulin antibodies CPT 86337 | $88.00 | $176.00 | $21.84 – $35.90 | 5 |
| Mayo iodine CPT 83789 | $83.00 | $166.00 | $24.59 – $30.28 | 5 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $62.00 | $124.00 | $27.65 – $32.53 | 5 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $62.00 | $124.00 | $27.65 – $32.53 | 5 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $72.00 | $144.00 | $13.52 – $21.71 | 5 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $56.50 | $113.00 | $13.05 – $21.46 | 5 |
| Mayo legionella antibody CPT 86713 | $42.00 | $84.00 | $15.61 – $25.67 | 5 |
| Mayo leptospira antibody igm CPT 86720 | $67.50 | $135.00 | $16.52 – $22.12 | 5 |
| Mayo lipoprotein electrophoresis CPT 83700 | not published | not published | $11.49 – $18.88 | 5 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $69.50 | $139.00 | $15.80 – $25.97 | 5 |
| Mayo manganese CPT 83785 | $111.50 | $223.00 | $27.18 – $41.23 | 5 |
| Mayo metanephrines plasma CPT 83835 | $78.50 | $157.00 | $17.28 – $28.40 | 5 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | not published | not published | $0.03 – $26.66 | 2 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $52.50 | $105.00 | $12.29 – $22.08 | 5 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $17.50 | $35.00 | $18.77 – $22.08 | 5 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $65.00 | $130.00 | $14.84 – $24.40 | 5 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $176.00 | $352.00 | $19.01 – $22.96 | 5 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $395.00 | $790.00 | $139.74 – $164.40 | 5 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $188.90 – $222.24 | 5 |
| Mayo muramidase CPT 85549 | $96.00 | $192.00 | $19.12 – $31.45 | 5 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $232.50 | $465.00 | $18.77 – $22.08 | 5 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $97.00 | $194.00 | $18.41 – $29.56 | 5 |
| Mayo myoglobin CPT 83874 | $59.50 | $119.00 | $13.18 – $21.65 | 5 |
| Mayo nickel CPT 83885 | $111.00 | $222.00 | $25.00 – $41.08 | 5 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | not published | not published | $0.03 – $41.98 | 2 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | not published | not published | $0.03 – $29.64 | 2 |
| Mayo opatu oxycodone definitive assay CPT 80365 | not published | not published | $0.03 – $29.64 | 2 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $75.50 | $151.00 | $21.63 – $27.60 | 5 |
| Mayo organic acids qualitative each specimen CPT 83919 | $75.50 | $151.00 | $16.78 – $27.60 | 5 |
| Mayo oxalate 24 hour urine CPT 83945 | $191.00 | $382.00 | $14.74 – $21.59 | 5 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $11.76 – $19.34 | 5 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $66.50 | $133.00 | $15.33 – $25.20 | 5 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $609.50 | $1,219.00 | $12.29 – $20.21 | 5 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | not published | not published | $35.79 – $58.85 | 5 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $35.50 | $71.00 | $18.34 – $30.36 | 5 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $75.50 | $151.00 | $14.04 – $23.08 | 5 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $38.50 | $77.00 | $8.61 – $14.16 | 5 |
| Mayo pregnenolone CPT 84140 | $90.50 | $181.00 | $21.08 – $34.67 | 5 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $31.50 | $63.00 | $16.92 – $27.82 | 5 |
| Mayo proinsulin CPT 84206 | $78.50 | $157.00 | $27.22 – $29.87 | 5 |
| Mayo psaft prostate specific antigen free CPT 84154 | $81.50 | $163.00 | $18.76 – $30.84 | 5 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $890.50 | $1,781.00 | $18.77 – $22.66 | 5 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $66.50 | $133.00 | $13.63 – $22.39 | 5 |
| Mayo receptor assay transferrin soluble CPT 84238 | $158.50 | $317.00 | $37.30 – $61.31 | 5 |
| Mayo renin CPT 84244 | $101.00 | $202.00 | $22.43 – $36.88 | 5 |
| Mayo repu protein electrophoresis urine CPT 84166 | $83.00 | $166.00 | $18.19 – $29.90 | 5 |
| Mayo selenium CPT 84255 | $116.00 | $232.00 | $26.04 – $42.80 | 5 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $15.81 – $25.98 | 5 |
| Mayo serotonin CPT 84260 | $80.00 | $160.00 | $31.60 – $51.94 | 5 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $86.00 | $172.00 | $19.74 – $32.46 | 5 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $103.00 | $206.00 | $14.00 – $23.00 | 5 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | not published | not published | $93.87 – $96.63 | 4 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $19.50 | $39.00 | $4.36 – $7.15 | 5 |
| Mayo tau phosphorylated 217 each CPT 84393 | not published | not published | $131.50 – $135.37 | 4 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $475.00 | $950.00 | $213.10 – $342.02 | 5 |
| Mayo tgrp testosterone free CPT 84402 | $116.00 | $232.00 | $25.98 – $42.68 | 5 |
| Mayo tgrp testosterone total CPT 84403 | $118.00 | $236.00 | $26.33 – $43.30 | 5 |
| Mayo thiopurine s-methyltransferase CPT 84433 | not published | not published | $22.61 – $26.60 | 5 |
| Mayo thyroglobulin CPT 84432 | $74.00 | $148.00 | $16.38 – $26.93 | 5 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $46.50 | $93.00 | $10.38 – $17.06 | 5 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $55.00 | $110.00 | $12.64 – $20.78 | 5 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | not published | not published | $0.03 – $29.64 | 2 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | not published | not published | $52.31 – $87.06 | 5 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $62.00 | $124.00 | $14.44 – $17.44 | 5 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $64.50 | $129.00 | $13.81 – $22.13 | 5 |
| Mayo vasoactive intestinal peptide CPT 84586 | $153.00 | $306.00 | $36.04 – $59.24 | 5 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $88.50 | $177.00 | $20.64 – $33.94 | 5 |
| Mayo vitamin b3 (niacin) CPT 84591 | $51.50 | $103.00 | $17.40 – $19.44 | 5 |
| Mayo vitamin k CPT 84597 | $59.50 | $119.00 | $13.99 – $22.98 | 5 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $72.00 | $144.00 | $13.52 – $21.71 | 5 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Mcoln1 gene CPT 81290 | not published | not published | $40.10 – $47.17 | 5 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $3,256.29 – $13,397.00 | 6 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $1,600.27 – $8,246.00 | 6 |
| Mcrscp xm hair pluck/clipped CPT 96902 | $42.00 | $84.00 | $64.56 – $64.56 | 1 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $3,304.00 – $8,246.00 | 5 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $371.37 – $382.29 | 4 |
| Measure kidney pressure CPT 50396 | not published | not published | $693.95 – $1,547.00 | 6 |
| Measurement post void urine by ultrasound CPT 51798 | $79.00 | $158.00 | $58.71 – $2,845.00 | 6 |
| Measure ureter pressure CPT 50686 | not published | not published | $128.06 – $2,845.00 | 6 |
| Mecasermin injection HCPCS J2170 | not published | not published | $397.47 – $397.47 | 1 |
| Mechlorethamine hcl inj HCPCS J9230 | not published | not published | $837.14 – $837.14 | 1 |
| #mec-opiates CPT 80356 | not published | not published | $0.03 – $29.64 | 2 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $153.00 – $180.00 | 5 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $538.43 – $633.44 | 5 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $122.40 – $144.00 | 5 |
| Medial canthopexy CPT 21280 | not published | not published | $3,299.54 – $10,995.00 | 6 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $3,304.00 – $10,995.00 | 5 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $3,304.00 – $10,995.00 | 5 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $371.37 – $382.29 | 4 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | not published | not published | $1.46 – $1.46 | 1 |
| Meg evoked single CPT 95966 | not published | not published | $854.62 – $879.75 | 4 |
| Meg spontaneous CPT 95965 | not published | not published | $854.62 – $879.75 | 4 |
| Melphalan oral 2 mg HCPCS J8600 | not published | not published | $24.75 – $24.75 | 1 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | not published | not published | $163,977.50 – $163,977.50 | 1 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | $132.48 | $264.96 | not published | 0 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $3,304.00 – $13,397.00 | 5 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | not published | not published | $19.37 – $19.37 | 1 |
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.