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 |
|---|---|---|---|---|
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $3,587.00 | $7,174.00 | $511.00 – $6,716.00 | 3 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $3,120.00 | $6,240.00 | $3,256.29 – $8,246.00 | 6 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $6,857.50 | $13,715.00 | $3,256.29 – $8,246.00 | 6 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $377.90 – $412.26 | 4 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | not published | not published | $234.34 – $234.34 | 1 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $2,269.00 | $4,538.00 | $1,571.00 – $3,344.08 | 6 |
| Pr application of long arm splint CPT 29105 | $171.50 | $343.00 | $161.72 – $2,845.00 | 6 |
| Pr application splint static short arm CPT 29125 | $297.00 | $594.00 | $132.41 – $2,845.00 | 6 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | not published | not published | $37.17 – $38.26 | 4 |
| Pr biopsy skin punch single lesion CPT 11104 | $367.50 | $735.00 | $404.56 – $511.00 | 5 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $3,304.00 – $13,121.51 | 6 |
| Pr correction hammertoe CPT 28285 | $1,523.50 | $3,047.00 | $3,256.29 – $5,978.00 | 6 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $44.50 | $89.00 | not published | 0 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prcrd drg 6+yr without anomly CPT 33017 | $1,464.00 | $2,928.00 | $1,547.00 – $1,547.00 | 1 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $3,709.50 | $7,419.00 | $1,571.00 – $5,978.00 | 6 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $354.00 | $708.00 | $199.67 – $511.00 | 5 |
| Prealbumin CPT 84134 | $65.00 | $130.00 | $14.88 – $24.46 | 5 |
| Prednisolone acetate inj HCPCS J2650 | not published | not published | $1.14 – $1.14 | 1 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | not published | not published | $1.59 – $1.59 | 1 |
| Prednisone 1 mg tablet HCPCS J7512 | not published | not published | $0.03 – $0.03 | 1 |
| Pregabalin - sendout CPT 80366 | not published | not published | $0.03 – $29.64 | 2 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Pregnancy associated plasma protein-a CPT 84163 | $520.50 | $1,041.00 | $15.35 – $25.24 | 5 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $428.00 | $856.00 | $104.04 – $107.10 | 4 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $377.00 | $754.00 | $104.04 – $107.10 | 4 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $214.89 – $221.21 | 4 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $371.37 – $382.29 | 4 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $371.37 – $382.29 | 4 |
| Preparation for bladder xray CPT 51605 | $1,514.00 | $3,028.00 | $511.00 – $511.00 | 1 |
| Preparation palate mold CPT 42280 | not published | not published | $511.00 – $2,845.00 | 6 |
| Prepare donor heart CPT 33944 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepare donor intestine CPT 44715 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepare donor lung double CPT 32856 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepare donor lung single CPT 32855 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $51.86 – $53.39 | 5 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $2,004.00 – $2,004.00 | 1 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepare penis study CPT 54230 | not published | not published | $511.00 – $2,004.00 | 2 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $511.00 – $2,670.00 | 2 |
| Prep cadaver renal allograft CPT 50323 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $511.00 – $511.00 | 1 |
| Prep donor intestine/artery CPT 44721 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor intestine/venous CPT 44720 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor liver 3-segment CPT 47144 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor liver/arterial CPT 47147 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor liver lobe split CPT 47145 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor liver/venous CPT 47146 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor liver whole CPT 47143 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep donor renal graft CPT 50325 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prepj skn cll ssp agrft 1st CPT 15013 | not published | not published | $7,062.71 – $13,397.00 | 5 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $511.00 – $2,004.00 | 2 |
| Pre-plan 3d model w/ccta HCPCS C9793 | not published | not published | $854.62 – $879.75 | 4 |
| Prep renal graft/arterial CPT 50328 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep renal graft/ureteral CPT 50329 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep renal graft/venous CPT 50327 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Prep skin to 100cm2 other CPT 15004 | $1,257.50 | $2,515.00 | $404.56 – $1,571.00 | 6 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $3,210.00 | $6,420.00 | $735.52 – $3,276.00 | 6 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | $356.50 | $713.00 | $511.00 – $2,004.00 | 2 |
| Pressure max expiratory/inspiratory CPT 94799 | $111.00 | $222.00 | $128.06 – $131.82 | 4 |
| Pressure treatment esophagus CPT 43460 | $2,035.50 | $4,071.00 | $1,547.00 – $1,547.00 | 1 |
| Pressure velocity wire add ves CPT 93572 | $1,538.50 | $3,077.00 | $511.00 – $511.00 | 1 |
| Pre-tibial shell molded to p HCPCS L2340 | $439.88 | $879.75 | not published | 0 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | not published | not published | $16.50 – $174.12 | 5 |
| Pretreat rbc absorption reference CPT 86978 | $227.50 | $455.00 | $16.50 – $60.44 | 5 |
| Pretreat rbc density gradient separation reference CPT 86972 | $237.50 | $475.00 | $16.50 – $174.12 | 5 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $237.50 | $475.00 | $16.50 – $60.44 | 5 |
| Pretreat rbc w enzyme reference CPT 86971 | $237.50 | $475.00 | $16.50 – $174.12 | 5 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $319.50 | $639.00 | not published | 0 |
| Prev med cnsl indiv apprx 15 CPT 99401 | $118.00 | $236.00 | not published | 0 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | $319.50 | $639.00 | $132.50 – $136.39 | 4 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $2,343.50 | $4,687.00 | $1,010.00 – $1,692.01 | 6 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $1,475.00 | $2,950.00 | $1,010.00 – $3,276.00 | 6 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $639.50 | $1,279.00 | $404.56 – $1,010.00 | 6 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $3,836.96 – $8,246.00 | 5 |
| Prgrmg dev eval impltbl sys CPT 93260 | $56.50 | $113.00 | $37.14 – $38.23 | 4 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $128.50 | $257.00 | $37.14 – $38.23 | 4 |
| Prgrmg dev eval scrms ip CPT 93285 | $325.50 | $651.00 | $37.14 – $38.23 | 4 |
| Prgrmg eval implantable dfb CPT 93282 | $157.00 | $314.00 | $37.14 – $38.23 | 4 |
| Prgrmg eval implantable dfb CPT 93283 | $176.50 | $353.00 | $37.14 – $38.23 | 4 |
| Prgrmg eval implantable dfb CPT 93284 | $201.50 | $403.00 | $37.14 – $38.23 | 4 |
| Prgr stim/pace a/iv drug CPT 93623 | $236.00 | $472.00 | not published | 0 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $7,658.50 | $15,317.00 | $6,716.00 – $18,735.48 | 6 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $1,598.50 | $3,197.00 | $511.00 – $2,670.00 | 2 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $394.00 | $788.00 | $404.56 – $1,010.00 | 6 |
| Pr incision & drainage abscess simple/single CPT 10060 | $398.00 | $796.00 | $199.67 – $2,845.00 | 6 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $548.00 | $1,096.00 | $303.27 – $1,571.00 | 6 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $398.00 | $796.00 | $404.56 – $2,845.00 | 6 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | not published | not published | $132.50 – $136.39 | 4 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | not published | not published | $132.50 – $136.39 | 4 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $98.50 | $197.00 | not published | 0 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $2,185.00 | $4,370.00 | not published | 0 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $315.88 – $1,010.00 | 6 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $2,366.07 – $5,978.00 | 6 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | not published | not published | $300.58 – $309.43 | 4 |
| Procalcitonin CPT 84145 | $68.00 | $136.00 | $27.76 – $33.31 | 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.