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 |
|---|---|---|---|---|
| MRA w/cont, abd HCPCS C8900 | $1,781.50 | $3,563.00 | $347.20 – $357.41 | 4 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,781.50 | $3,563.00 | $347.20 – $357.41 | 4 |
| Mra, w/dye, spinal canal HCPCS C8931 | not published | not published | $347.20 – $357.41 | 4 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $347.20 – $357.41 | 4 |
| MRA without cont, abd HCPCS C8901 | $1,713.50 | $3,427.00 | $237.46 – $244.44 | 4 |
| MRA without cont, lwr ext HCPCS C8913 | $1,713.50 | $3,427.00 | $237.46 – $244.44 | 4 |
| Mra, without dye, spinal canal HCPCS C8932 | not published | not published | $237.46 – $244.44 | 4 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $237.46 – $244.44 | 4 |
| MRA without fol w/cont, abd HCPCS C8902 | $1,885.00 | $3,770.00 | $347.20 – $357.41 | 4 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,885.00 | $3,770.00 | $347.20 – $357.41 | 4 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $1,885.00 | $3,770.00 | $347.20 – $357.41 | 4 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $2,246.00 | $4,492.00 | $347.20 – $357.41 | 4 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $2,246.00 | $4,492.00 | $347.20 – $357.41 | 4 |
| Mr elastography CPT 76391 | $1,204.50 | $2,409.00 | $237.46 – $244.44 | 4 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $3,304.00 – $29,725.00 | 5 |
| MRI brain w/dye CPT 70558 | not published | not published | $174.56 – $179.69 | 4 |
| MRI brain without dye CPT 70557 | not published | not published | $543.79 – $559.79 | 4 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $174.56 – $179.69 | 4 |
| MRI breast c- unilateral CPT 77046 | $2,757.50 | $5,515.00 | $237.46 – $244.44 | 4 |
| MRI breast without cont bi CPT 77047 | $3,079.50 | $6,159.00 | $237.46 – $244.44 | 4 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $1,659.00 | $3,318.00 | $237.46 – $244.44 | 4 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $2,357.00 | $4,714.00 | $347.20 – $357.41 | 4 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $2,935.50 | $5,871.00 | $780.16 – $803.10 | 4 |
| MRI chest without contrast CPT 71550 | $2,029.00 | $4,058.00 | $237.46 – $244.44 | 4 |
| MRI chest without & w/contrast CPT 71552 | $3,771.50 | $7,543.00 | $347.20 – $357.41 | 4 |
| MRI chest w IV cont CPT 71551 | $2,241.00 | $4,482.00 | $780.16 – $803.10 | 4 |
| MRI compatible system HCPCS L0859 | $1,042.24 | $2,084.49 | not published | 0 |
| MRI fetal ea addl gestation CPT 74713 | $427.00 | $854.00 | not published | 0 |
| MRI fetal sngl/1st gestation CPT 74712 | $539.00 | $1,078.00 | $237.46 – $244.44 | 4 |
| MRI guid ndl plc s&i CPT 77021 | $1,419.00 | $2,838.00 | not published | 0 |
| MRI loex nonjt w IV cont CPT 73719 | $2,092.50 | $4,185.00 | $347.20 – $357.41 | 4 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $1,567.00 | $3,134.00 | $237.46 – $244.44 | 4 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,279.50 | $4,559.00 | $347.20 – $357.41 | 4 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,634.50 | $3,269.00 | $237.46 – $244.44 | 4 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $3,075.50 | $6,151.00 | $347.20 – $357.41 | 4 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,708.00 | $3,416.00 | $347.20 – $357.41 | 4 |
| MRI tmj CPT 70336 | $1,895.50 | $3,791.00 | $237.46 – $244.44 | 4 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,895.50 | $3,791.00 | $237.46 – $244.44 | 4 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,490.50 | $4,981.00 | $347.20 – $357.41 | 4 |
| MRI upper extremity w/dye CPT 73219 | $2,105.50 | $4,211.00 | $347.20 – $357.41 | 4 |
| MRI w/cont, breast, bi HCPCS C8906 | $3,388.00 | $6,776.00 | $347.20 – $357.41 | 4 |
| MRI w/cont, breast, uni HCPCS C8903 | $3,033.50 | $6,067.00 | $174.56 – $179.69 | 4 |
| MRI without fol w/cont, breast HCPCS C8908 | $3,558.00 | $7,116.00 | $347.20 – $357.41 | 4 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $3,203.50 | $6,407.00 | $347.20 – $357.41 | 4 |
| Mr safety determination physician/other qhp CPT 76016 | not published | not published | $86.61 – $89.15 | 4 |
| Mr safety implt pos&/immoblj CPT 76019 | not published | not published | $58.71 – $60.44 | 4 |
| Mr sfty med physics xm cstmz CPT 76017 | not published | not published | $237.46 – $244.44 | 4 |
| Mr spectroscopy CPT 76390 | $1,830.50 | $3,661.00 | $86.61 – $89.15 | 4 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $182.05 – $223.97 | 5 |
| Msh2 gene full seq CPT 81295 | not published | not published | $182.05 – $400.78 | 5 |
| Msh2 gene known variants CPT 81296 | not published | not published | $155.44 – $354.62 | 5 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $194.02 – $249.90 | 5 |
| Msh6 gene full seq CPT 81298 | not published | not published | $345.40 – $673.94 | 5 |
| Msh6 gene known variants CPT 81299 | $216.00 | $432.00 | $193.49 – $323.40 | 5 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $3,338.00 – $13,397.00 | 5 |
| Mthfr gene analy common variants CPT 81291 | $184.00 | $368.00 | $66.65 – $71.46 | 5 |
| M.tuberculo dna dir probe CPT 87555 | $19.50 | $39.00 | $27.42 – $33.62 | 5 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $43.70 – $71.82 | 5 |
| Mucin synovial fluid CPT 83872 | not published | not published | $5.98 – $9.83 | 5 |
| Mucopolysaccharides CPT 83864 | $90.50 | $181.00 | $29.07 – $33.38 | 5 |
| Mucormycosis antibody CPT 86732 | not published | not published | $15.30 – $22.12 | 5 |
| Multifocal erg w/i&r CPT 92274 | not published | not published | $128.06 – $131.82 | 4 |
| Multiple sleep latency test CPT 95805 | $1,475.50 | $2,951.00 | $854.62 – $879.75 | 4 |
| Mumps antibody igg CPT 86735 | $58.50 | $117.00 | $13.31 – $21.88 | 5 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Muscle test cran nerv unilat CPT 95867 | $145.00 | $290.00 | $214.89 – $221.21 | 4 |
| Muscle test hemidiaphragm CPT 95866 | not published | not published | $128.06 – $131.82 | 4 |
| Muscle test larynx CPT 95865 | not published | not published | $132.41 – $136.30 | 4 |
| Muscle test one fiber CPT 95872 | $265.00 | $530.00 | $214.89 – $221.21 | 4 |
| Muscle transfers CPT 23397 | not published | not published | $5,418.00 – $10,995.00 | 6 |
| Muscle transfer shoulder/arm CPT 23395 | not published | not published | $4,007.00 – $10,995.00 | 6 |
| Musc myoq/fscq flp h&n pedcl CPT 15733 | not published | not published | $3,304.00 – $8,246.00 | 5 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | $3,338.00 – $8,246.00 | 6 |
| Mycobacteria dna amp probe CPT 87551 | not published | not published | $49.20 – $58.85 | 5 |
| Mycobacteria dna dir probe CPT 87550 | not published | not published | $20.45 – $33.62 | 5 |
| Mycobacteria dna quant CPT 87552 | not published | not published | $43.70 – $71.82 | 5 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | not published | not published | $0.42 – $0.42 | 1 |
| Mycophenolic acid HCPCS J7518 | not published | not published | $1.33 – $1.33 | 1 |
| Mycoplasma antibody igm CPT 86738 | $59.00 | $118.00 | $13.50 – $22.21 | 5 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $386.50 | $773.00 | $178.91 – $210.48 | 5 |
| Myelogphy 2/> spine regions CPT 72270 | not published | not published | $780.16 – $803.10 | 4 |
| Myelography l-s spine CPT 72265 | $992.50 | $1,985.00 | $780.16 – $803.10 | 4 |
| Myelography neck spine CPT 72240 | $909.50 | $1,819.00 | $780.16 – $803.10 | 4 |
| Myelography thoracic spine CPT 72255 | $919.00 | $1,838.00 | $780.16 – $803.10 | 4 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $2,999.50 | $5,999.00 | $780.16 – $4,314.00 | 6 |
| Myelography via inj w/s&i cervical CPT 62302 | $679.00 | $1,358.00 | $780.16 – $4,314.00 | 6 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $1,252.00 | $2,504.00 | $780.16 – $4,314.00 | 6 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,252.00 | $2,504.00 | $780.16 – $4,314.00 | 6 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $179.00 | $358.00 | $11.76 – $19.34 | 5 |
| Myocardial resection 33542 CPT 33542 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $1,423.08 – $1,464.94 | 4 |
| Myocrd img pet 1 std w/ct CPT 78429 | not published | not published | $1,423.08 – $1,464.94 | 4 |
| Myocrd img pet 2rtracer CT CPT 78433 | $2,263.00 | $4,526.00 | not published | 0 |
| Myocrd img pet mlt rst&strs CPT 78492 | not published | not published | $1,423.08 – $1,464.94 | 4 |
| Myocrd img pet rst/strs w/ct CPT 78430 | not published | not published | $1,423.08 – $1,464.94 | 4 |
| Myomectomy abdom complex CPT 58146 | not published | not published | $8,246.00 – $8,246.00 | 1 |
| Myomectomy abdom method CPT 58140 | not published | not published | $5,980.00 – $8,246.00 | 2 |
| Myomectomy vag method CPT 58145 | not published | not published | $3,221.58 – $5,978.00 | 6 |
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.