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 |
|---|---|---|---|---|
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $511.00 – $2,004.00 | 2 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $3,338.00 – $10,995.00 | 6 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Ot evaluation high complexity patient/family CPT 97167 | $228.50 | $457.00 | $101.60 – $104.59 | 4 |
| Ot evaluation low complexity patient/family CPT 97165 | $164.00 | $328.00 | $101.60 – $104.59 | 4 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $207.50 | $415.00 | $101.60 – $104.59 | 4 |
| Other bone graft microvasc CPT 20962 | not published | not published | $3,338.00 – $10,995.00 | 5 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $23.59 – $37.49 | 5 |
| Oth resp proc, group HCPCS G0239 | $139.00 | $278.00 | $37.17 – $38.26 | 4 |
| Oth resp proc, indiv HCPCS G0238 | $61.50 | $123.00 | not published | 0 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $55.00 | $110.00 | $50.42 – $51.90 | 4 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $79.00 | $158.00 | $46.41 – $47.78 | 4 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $61.00 | $122.00 | $27.95 – $28.77 | 4 |
| Otoplasty 69300 CPT 69300 | not published | not published | $3,299.54 – $5,978.00 | 6 |
| Ot re-evaluation patient/family CPT 97168 | $86.00 | $172.00 | $69.12 – $71.15 | 4 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $50.50 | $101.00 | $35.32 – $36.36 | 4 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $88.50 | $177.00 | $18.70 – $19.25 | 4 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $88.50 | $177.00 | $19.95 – $20.54 | 4 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $65.50 | $131.00 | $29.30 – $30.17 | 4 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $58.00 | $116.00 | $33.02 – $33.99 | 4 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $37.50 | $75.00 | $32.65 – $33.61 | 4 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $4,007.00 – $8,246.00 | 5 |
| Ovine, 1000 usp units HCPCS J3472 | not published | not published | $366.04 – $366.04 | 1 |
| Ovulation tests CPT 84830 | not published | not published | $12.95 – $16.82 | 5 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $2.97 – $2.97 | 1 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | not published | not published | $0.21 – $0.21 | 1 |
| Oxymorphone hcl injection HCPCS J2410 | not published | not published | $8.45 – $8.45 | 1 |
| Oxytetracycline injection HCPCS J2460 | not published | not published | $2.49 – $2.49 | 1 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | not published | not published | $3.79 – $3.79 | 1 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $283.80 – $292.15 | 4 |
| Pabpn1 gene detc abnor allel CPT 81312 | $655.50 | $1,311.00 | $139.74 – $164.40 | 5 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | not published | not published | $0.29 – $0.29 | 1 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | not published | not published | $10.75 – $11.07 | 4 |
| Pad repl cerv collr univ adult HCPCS L0999 | $32.60 | $65.21 | not published | 0 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $339.46 – $708.63 | 5 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $307.38 – $361.62 | 5 |
| Palifermin injection HCPCS J2425 | not published | not published | $34.71 – $37.33 | 4 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | not published | not published | $15.41 – $15.87 | 4 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $445.48 – $458.59 | 4 |
| Palonosetron hcl HCPCS J2469 | not published | not published | $1.64 – $1.64 | 1 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | not published | not published | $35.01 – $35.01 | 1 |
| Pancreas removal/transplant CPT 48160 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pancreatectomy CPT 48146 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pancreatectomy CPT 48152 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pancreatectomy CPT 48154 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pancreatectomy 48153 CPT 48153 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pancreatorrhaphy CPT 48545 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $176.49 – $181.68 | 4 |
| Papaverin hcl injection HCPCS J2440 | not published | not published | $101.36 – $101.36 | 1 |
| Parathormone (pth) intact CPT 83970 | $186.50 | $373.00 | $42.11 – $69.20 | 5 |
| Parathyrdec/expl parathyr medstnl sternal/tthrc 60505 CPT 60505 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,216.50 | $2,433.00 | $540.36 – $556.26 | 4 |
| Parathyroid autotransplantation 60512 CPT 60512 | not published | not published | $511.00 – $3,304.00 | 2 |
| Parathyroid planar imaging CPT 78070 | $870.00 | $1,740.00 | $397.85 – $409.55 | 4 |
| Parathyroid planar img w/tomo spect CPT 78071 | $870.00 | $1,740.00 | $397.85 – $409.55 | 4 |
| Paravaginal defect repair 57284 CPT 57284 | not published | not published | $4,007.00 – $10,995.00 | 5 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $5,418.00 – $10,995.00 | 6 |
| Paricalcitol HCPCS J2501 | not published | not published | $2.52 – $2.52 | 1 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $160.00 | $320.00 | $199.67 – $2,845.00 | 6 |
| Parotid duct diversion CPT 42507 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Parotid duct diversion CPT 42509 | not published | not published | $3,338.00 – $10,995.00 | 6 |
| Parotid duct diversion CPT 42510 | not published | not published | $3,299.54 – $10,995.00 | 6 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | not published | not published | $3,304.00 – $13,397.00 | 5 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Partial complicated cystectomy 51555 CPT 51555 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial exc bone humerus CPT 24140 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Partial excision of lip CPT 40500 | not published | not published | $1,571.00 – $3,388.50 | 6 |
| Partial hip replacement CPT 27125 | not published | not published | $4,339.00 – $13,397.00 | 5 |
| Partial hysterectomy CPT 58180 | not published | not published | $5,980.00 – $8,246.00 | 2 |
| Partial proctectomy CPT 45113 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial proctectomy; perineal 45123 CPT 45123 | not published | not published | $13,397.00 – $13,397.00 | 1 |
| Partial removal donor liver CPT 47140 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal donor liver CPT 47141 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal donor liver CPT 47142 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal finger bone CPT 26235 | not published | not published | $1,600.27 – $3,895.00 | 6 |
| Partial removal finger bone CPT 26236 | $1,836.00 | $3,672.00 | $1,600.27 – $3,895.00 | 6 |
| Partial removal foot fascia CPT 28060 | $3,758.50 | $7,517.00 | $1,571.00 – $5,978.00 | 6 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Partial removal of bladder CPT 51550 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of esophagus CPT 43116 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of esophagus CPT 43118 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of esophagus CPT 43121 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of esophagus CPT 43123 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of esophagus 43117 CPT 43117 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of esophagus 43122 CPT 43122 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of eye fluid CPT 67005 | not published | not published | $2,296.74 – $5,978.00 | 6 |
| Partial removal of eye fluid CPT 67010 | not published | not published | $2,296.74 – $5,978.00 | 6 |
| Partial removal of fibula CPT 27641 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Partial removal of foot bone CPT 28288 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Partial removal of hand bone CPT 26230 | not published | not published | $3,256.29 – $5,418.00 | 6 |
| Partial removal of heart sac 33030 CPT 33030 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of larynx CPT 31367 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of larynx CPT 31368 | not published | not published | $1,547.00 – $1,547.00 | 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.