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 |
|---|---|---|---|---|
| Perc drug-el cor stent bran HCPCS C9601 | $15,784.50 | $31,569.00 | $511.00 – $2,004.00 | 2 |
| Perc drug-el cor stent sing HCPCS C9600 | $15,784.50 | $31,569.00 | $5,700.00 – $11,798.51 | 4 |
| Perc rf ablate renal tumor CPT 50592 | $7,717.00 | $15,434.00 | $1,010.00 – $13,397.00 | 6 |
| Percut ablate liver rf CPT 47382 | $5,567.00 | $11,134.00 | $3,338.00 – $13,397.00 | 5 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,464.00 | $2,928.00 | $1,547.00 – $1,612.67 | 5 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | $851.50 | $1,703.00 | $1,547.00 – $1,547.00 | 1 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $3,338.00 – $8,246.00 | 6 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $3,221.58 – $5,978.00 | 6 |
| Peripheral vascular rehab CPT 93668 | $35.00 | $70.00 | $58.71 – $60.44 | 4 |
| Peri-proc device eval icd CPT 93287 | $72.00 | $144.00 | not published | 0 |
| Peri-proc device eval pm CPT 93286 | $63.00 | $126.00 | not published | 0 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $1,010.00 – $13,397.00 | 6 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $543.79 – $559.79 | 4 |
| Perit-vens shunt pat tst CPT 78291 | $493.50 | $987.00 | $397.85 – $409.55 | 4 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $16.91 – $16.91 | 1 |
| Perq art m-thrombect &/nfs CPT 61645 | $33,944.50 | $67,889.00 | $1,547.00 – $4,339.00 | 2 |
| Perq clsr tcat l atr apndge CPT 33340 | $4,657.50 | $9,315.00 | $10,995.00 – $10,995.00 | 1 |
| Perq dev breast 1st mr guide CPT 19287 | $333.50 | $667.00 | $704.73 – $1,547.00 | 6 |
| Perq dev breast 1st strtctc CPT 19283 | $1,210.50 | $2,421.00 | $704.73 – $1,547.00 | 6 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $4,007.00 – $10,995.00 | 5 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $3,338.00 – $10,995.00 | 5 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $5,700.00 – $29,725.00 | 5 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $5,700.00 – $29,725.00 | 5 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $5,980.00 – $29,725.00 | 5 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | not published | not published | $5,980.00 – $29,725.00 | 5 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $511.00 – $2,004.00 | 2 |
| Perq plmt bile duct stent CPT 47538 | $7,473.00 | $14,946.00 | $3,304.00 – $13,397.00 | 6 |
| Perq plmt bile duct stent CPT 47539 | $7,433.50 | $14,867.00 | $3,304.00 – $13,397.00 | 6 |
| Perq plmt bile duct stent CPT 47540 | $7,433.50 | $14,867.00 | $3,304.00 – $13,397.00 | 6 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $994.00 | $1,988.00 | $248.65 – $511.00 | 5 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $2,004.00 – $5,978.00 | 6 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $1,010.00 – $1,010.00 | 1 |
| Perq transcath closure each CPT 93592 | not published | not published | $511.00 – $2,004.00 | 2 |
| Perq transcath closure pda CPT 93582 | $8,740.50 | $17,481.00 | $5,700.00 – $39,612.00 | 5 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $5,700.00 – $62,241.00 | 5 |
| Perq transcath cls mitral CPT 93590 | $27,393.00 | $54,786.00 | $5,700.00 – $62,241.00 | 5 |
| Perq transcath septal reduxn CPT 93583 | $13,982.50 | $27,965.00 | $1,547.00 – $5,700.00 | 2 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Perq tx malar fracture CPT 21355 | not published | not published | $3,299.54 – $10,995.00 | 6 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $1,571.00 – $6,050.24 | 6 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $3,299.54 – $10,995.00 | 6 |
| Pertussis ag if CPT 87265 | $58.50 | $117.00 | $12.22 – $20.11 | 5 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $17.36 – $17.87 | 4 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $63.34 – $65.20 | 4 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $40.00 | $80.00 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $4,409.00 | $8,818.00 | $1,423.08 – $1,464.94 | 4 |
| Pet CT whole body initial CPT 78816 | $4,409.00 | $8,818.00 | $1,423.08 – $1,464.94 | 4 |
| Pet fdg brain metoblic eval sb CPT 78608 | $4,816.00 | $9,632.00 | $1,423.08 – $1,464.94 | 4 |
| Pet image full body CPT 78813 | $5,425.50 | $10,851.00 | $1,423.08 – $1,464.94 | 4 |
| Pet image ltd area CPT 78811 | $5,425.50 | $10,851.00 | $1,288.43 – $1,326.33 | 4 |
| Pet image skull-thigh CPT 78812 | $5,425.50 | $10,851.00 | $1,423.08 – $1,464.94 | 4 |
| Pet image w/ct lmtd CPT 78814 | $4,409.00 | $8,818.00 | $1,423.08 – $1,464.94 | 4 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $397.85 – $409.55 | 4 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $9,310.00 | $18,620.00 | not published | 0 |
| Phalangectomy ea toe 28150 CPT 28150 | $2,369.50 | $4,739.00 | $3,256.29 – $5,978.00 | 6 |
| Ph body fluid CPT 83986 | $16.00 | $32.00 | $3.65 – $6.00 | 5 |
| Phencyclidine (pcp) CPT 83992 | not published | not published | $0.03 – $24.65 | 2 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | not published | not published | $85.57 – $85.57 | 1 |
| Phenobarbital therapeutic drug level CPT 80184 | $30.50 | $61.00 | $15.61 – $19.21 | 5 |
| Phentolaine mesylate inj HCPCS J2760 | not published | not published | $440.66 – $453.62 | 4 |
| Phenylep ketorolac opth soln HCPCS J1097 | not published | not published | $98.85 – $101.76 | 4 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | not published | not published | $1.30 – $1.30 | 1 |
| Phenytoin total therapeutic drug level CPT 80185 | $78.00 | $156.00 | $13.52 – $22.22 | 5 |
| Phlebotomy therapeutic CPT 99195 | $184.00 | $368.00 | $132.41 – $136.30 | 4 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $5,591.00 | $11,182.00 | $3,142.32 – $8,246.00 | 6 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $5,591.00 | $11,182.00 | $3,142.32 – $8,246.00 | 6 |
| Phosphorus CPT 84100 | $22.50 | $45.00 | $4.83 – $7.96 | 5 |
| Phosphorus 24 hour urine CPT 84105 | $24.50 | $49.00 | $5.90 – $8.68 | 5 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | $131.00 | $262.00 | $58.71 – $60.44 | 4 |
| Photochemotherapy puva CPT 96912 | not published | not published | $58.71 – $60.44 | 4 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $404.56 – $416.46 | 4 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $511.00 – $511.00 | 1 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $511.00 – $511.00 | 1 |
| Photo patch test CPT 95052 | not published | not published | $58.71 – $60.44 | 4 |
| Photopheresis CPT 36522 | not published | not published | $2,670.00 – $10,995.00 | 5 |
| Photosensitivity tests CPT 95056 | not published | not published | $132.41 – $136.30 | 4 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $29.60 – $53.39 | 5 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $29.60 – $174.12 | 5 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $28.78 – $29.63 | 5 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | not published | not published | $6.15 – $6.15 | 1 |
| Pierce earlobes 69090 CPT 69090 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $365.40 | $730.80 | $353.42 – $363.81 | 4 |
| Pik3ca gene trgt seq alys CPT 81309 | $383.50 | $767.00 | $280.33 – $329.80 | 5 |
| Pild/placebo control clin tr HCPCS G0276 | not published | not published | $7,221.37 – $13,397.00 | 5 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $446.60 | $893.21 | not published | 0 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | $1,681.50 | $3,363.00 | $511.00 – $1,571.00 | 6 |
| Pin finger dislocation CPT 26776 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Pin finger fracture each CPT 26756 | $4,744.00 | $9,488.00 | $1,571.00 – $5,978.00 | 6 |
| Pin hand dislocation CPT 26676 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $1,571.00 – $3,344.08 | 6 |
| Pin service 60m per month HCPCS G0023 | $114.00 | $228.00 | not published | 0 |
| Pinworm exam CPT 87172 | $16.00 | $32.00 | $4.36 – $7.15 | 5 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $4.36 – $9.07 | 5 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | not published | not published | $3.15 – $3.15 | 1 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $591.07 – $971.71 | 5 |
| Place breast cath for rad CPT 19297 | not published | not published | $7,300.00 – $13,397.00 | 2 |
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.