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 |
|---|---|---|---|---|
| Partial removal of larynx CPT 31370 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of larynx CPT 31375 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of larynx CPT 31380 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of larynx CPT 31382 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of lip CPT 40530 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Partial removal of liver CPT 47125 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of liver CPT 47130 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of lung 32480 CPT 32480 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of nose CPT 30150 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Partial removal of pancreas CPT 48145 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of pancreas CPT 48150 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of penis CPT 54120 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $5,418.00 – $10,995.00 | 6 |
| Partial removal of radius CPT 25151 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Partial removal of radius CPT 25230 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Partial removal of rectum CPT 45111 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of rectum CPT 45114 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of rectum CPT 45116 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of rib CPT 21600 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Partial removal of sternum CPT 21620 | not published | not published | $3,256.29 – $10,995.00 | 5 |
| Partial removal of thyroid CPT 60220 | not published | not published | $1,571.00 – $13,397.00 | 6 |
| Partial removal of thyroid CPT 60225 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Partial removal of tibia CPT 27640 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Partial removal of toe CPT 28160 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Partial removal of tongue CPT 41120 | not published | not published | $4,007.00 – $10,995.00 | 6 |
| Partial removal of tongue CPT 41130 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Partial removal of ulna CPT 25119 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Partial removal of ulna CPT 25150 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Partial removal of ulna CPT 25240 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $3,221.58 – $5,978.00 | 5 |
| Partial removal tear gland CPT 68505 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Partial thyroid excision CPT 60210 | not published | not published | $3,338.00 – $13,397.00 | 5 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $3,338.00 – $13,397.00 | 5 |
| Part removal hip bone deep CPT 27071 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Part removal of metatarsal CPT 28110 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Part removal of metatarsal CPT 28113 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $3,256.29 – $5,978.00 | 6 |
| Part remove hip bone super CPT 27070 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Passy muir valve metal trach HCPCS L8501 | $110.23 | $220.46 | not published | 0 |
| Paste skin barrier .5oz adapt HCPCS A4406 | $15.52 | $31.05 | not published | 0 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $169.55 – $182.78 | 5 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $118.44 – $182.78 | 5 |
| Path clin consltj prolng svc CPT 80506 | not published | not published | $51.91 – $106.55 | 2 |
| Path clin consltj sf 5-20 CPT 80503 | not published | not published | $51.86 – $60.90 | 5 |
| Patient recorded spirometry CPT 94015 | not published | not published | $214.89 – $221.21 | 4 |
| Pca3/klk3 antigen CPT 81313 | $273.50 | $547.00 | $260.15 – $312.31 | 5 |
| Pcv21 vaccine im CPT 90684 | not published | not published | $619.71 – $619.71 | 1 |
| Pdgfra gene CPT 81314 | $505.50 | $1,011.00 | $336.10 – $395.41 | 5 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $12.42 | $24.84 | not published | 0 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | not published | not published | $199.67 – $511.00 | 5 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $128.06 – $131.82 | 4 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $128.06 – $131.82 | 4 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $2,053.37 – $3,895.00 | 6 |
| Pegademase bovine, 25 iu HCPCS J2504 | not published | not published | $938.31 – $938.31 | 1 |
| Pegaptanib sodium injection HCPCS J2503 | not published | not published | $2,003.03 – $2,003.03 | 1 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $28,992.54 – $29,845.26 | 4 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $55.60 – $93.59 | 4 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $133.78 – $137.72 | 4 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $108.46 – $111.65 | 4 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $188.61 – $194.15 | 4 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $101.11 – $104.08 | 4 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $140.72 – $144.86 | 4 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,734.05 – $3,843.88 | 4 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $225.86 – $239.56 | 4 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,544.00 | $3,088.00 | $174.56 – $179.69 | 4 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,131.00 | $2,262.00 | $174.56 – $179.69 | 4 |
| Pelvic CT scan (without contrast) CPT 72192 | $807.00 | $1,614.00 | $104.04 – $107.10 | 4 |
| Pelvic exenteration CPT 45126 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,012.00 | $6,024.00 | $347.20 – $357.41 | 4 |
| Pelvic MRI (with contrast) CPT 72196 | $2,092.50 | $4,185.00 | $347.20 – $357.41 | 4 |
| Pelvic MRI (without contrast) CPT 72195 | $1,691.00 | $3,382.00 | $237.46 – $244.44 | 4 |
| Pelvic ring fracture uni/bil HCPCS G0413 | $4,761.00 | $9,522.00 | $4,007.00 – $8,246.00 | 6 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $4,339.00 – $13,397.00 | 5 |
| Pelvic Ultrasound (complete) CPT 76856 | $491.50 | $983.00 | $104.04 – $107.10 | 4 |
| Pelvic Ultrasound (limited) CPT 76857 | $322.50 | $645.00 | $104.04 – $107.10 | 4 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $60.15 – $63.31 | 4 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $4.44 – $4.57 | 4 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $19.91 – $20.50 | 4 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $30.61 – $31.51 | 4 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | not published | not published | $2.09 – $2.09 | 1 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $89.19 – $124.21 | 2 |
| Penile injection CPT 54235 | $540.50 | $1,081.00 | $248.65 – $2,845.00 | 6 |
| Penile vascular study CPT 93980 | $900.50 | $1,801.00 | $104.04 – $107.10 | 4 |
| Penile vascular study CPT 93981 | $583.00 | $1,166.00 | $104.04 – $107.10 | 4 |
| Penile venous occlusion CPT 37790 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Penis plastic surgery CPT 54360 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Penis study CPT 54240 | not published | not published | $214.89 – $2,845.00 | 6 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $220.88 – $220.88 | 1 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $35.83 – $35.83 | 1 |
| Pentazocine injection HCPCS J3070 | not published | not published | $276.40 – $276.40 | 1 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $28.55 – $29.39 | 4 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,660.32 – $2,738.56 | 4 |
| Perc cryo ablate renal tum CPT 50593 | $14,122.50 | $28,245.00 | $6,716.00 – $13,397.00 | 6 |
| Perc d-e cor revasc chro add HCPCS C9608 | $9,870.50 | $19,741.00 | not published | 0 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $15,784.50 | $31,569.00 | $5,700.00 – $29,725.00 | 5 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $9,870.50 | $19,741.00 | $511.00 – $511.00 | 1 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $15,784.50 | $31,569.00 | $5,700.00 – $29,725.00 | 5 |
| Perc d-e cor stent ather br HCPCS C9603 | $11,596.50 | $23,193.00 | $511.00 – $511.00 | 1 |
| Perc d-e cor stent ather s HCPCS C9602 | $15,784.50 | $31,569.00 | $5,700.00 – $29,725.00 | 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.