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 |
|---|---|---|---|---|
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $114.50 | $229.00 | not published | 0 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $247.00 | $494.00 | not published | 0 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $308.50 | $617.00 | not published | 0 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $231.00 | $462.00 | $214.89 – $221.21 | 4 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | $155.00 | $310.00 | not published | 0 |
| Psychthrp grp 45-50min mcr HCPCS G0410 | $100.50 | $201.00 | not published | 0 |
| Psycl/nrpsyc tech 1st CPT 96138 | $180.00 | $360.00 | not published | 0 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $55.50 | $111.00 | $132.41 – $136.30 | 4 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | $37.00 | $74.00 | not published | 0 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | $15.00 | $30.00 | not published | 0 |
| Psytx complex interactive CPT 90785 | $19.00 | $38.00 | not published | 0 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $26.50 | $53.00 | $14.79 – $15.23 | 4 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $69.00 | $138.00 | $19.15 – $19.71 | 4 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $30.50 | $61.00 | $14.42 – $14.85 | 4 |
| Pt application of modality traction mechanical CPT 97012 | $40.50 | $81.00 | $14.44 – $14.87 | 4 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $105.12 – $315.00 | 5 |
| Pten gene full sequence CPT 81321 | not published | not published | $612.00 – $720.84 | 5 |
| Pten gene known fam variant CPT 81322 | not published | not published | $47.53 – $70.08 | 5 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $5,891.41 – $6,064.68 | 5 |
| Pt evaluation high complexity patient/family CPT 97163 | $228.50 | $457.00 | $98.92 – $101.83 | 4 |
| Pt evaluation low complexity patient/family CPT 97161 | $164.00 | $328.00 | $98.92 – $101.83 | 4 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $207.50 | $415.00 | $98.92 – $101.83 | 4 |
| Pt re-evaluation patient/family CPT 97164 | $90.00 | $180.00 | $68.12 – $70.12 | 4 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $124.00 | $248.00 | not published | 0 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $49.00 | $98.00 | $12.74 – $13.11 | 4 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $50.50 | $101.00 | $29.30 – $30.17 | 4 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $79.00 | $158.00 | $29.92 – $30.80 | 4 |
| Pt wheelchair management each 15 minutes CPT 97542 | $31.00 | $62.00 | $31.32 – $32.25 | 4 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $5,980.00 – $13,397.00 | 5 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $13,397.00 – $13,397.00 | 1 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,517.79 – $6,600.00 | 5 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $397.85 – $409.55 | 4 |
| Pulse ox continuous overnight monitoring CPT 94762 | $207.50 | $415.00 | $128.06 – $131.82 | 4 |
| Pulse ox multiple CPT 94761 | $213.50 | $427.00 | not published | 0 |
| Pulse ox single CPT 94760 | $38.50 | $77.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | $467.00 | $934.00 | $702.49 – $1,547.00 | 6 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $60.00 | $120.00 | $132.41 – $2,845.00 | 6 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $274.00 | $548.00 | $404.56 – $2,845.00 | 6 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $1,010.00 – $5,978.00 | 6 |
| Puncture spinal lumbar diagnostic CPT 62270 | $758.00 | $1,516.00 | $702.49 – $1,547.00 | 6 |
| Puraply 1 sq cm HCPCS Q4195 | $90.04 | $180.09 | not published | 0 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $80.50 | $161.00 | $511.00 – $2,004.00 | 2 |
| Pvb thoracic cont infusion CPT 64463 | $1,312.00 | $2,624.00 | $702.49 – $2,845.00 | 6 |
| Pvb thoracic single inj site CPT 64461 | $1,312.00 | $2,624.00 | $702.49 – $2,845.00 | 6 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Pyridoxine hcl 100 mg HCPCS J3415 | not published | not published | $43.91 – $43.91 | 1 |
| Pyruvate CPT 84210 | $48.50 | $97.00 | $14.77 – $18.20 | 5 |
| Pyruvate kinase CPT 84220 | $78.00 | $156.00 | $9.63 – $15.82 | 5 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $132.41 – $136.30 | 4 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,174.00 | $2,348.00 | $540.36 – $556.26 | 4 |
| Quant diff pulm perf w/imaging CPT 78597 | $785.00 | $1,570.00 | $397.85 – $409.55 | 4 |
| Quest t3 uptake CPT 84479 | $30.50 | $61.00 | $6.60 – $10.85 | 5 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $8.05 – $1,259.62 | 2 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $359.49 – $370.06 | 4 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $226.69 – $233.36 | 4 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $285.45 – $293.85 | 4 |
| Rabies vaccine id CPT 90676 | not published | not published | $241.60 – $248.70 | 4 |
| Radial keratotomy CPT 65771 | not published | not published | $2,845.00 – $5,980.00 | 3 |
| Radiation handling CPT 77790 | $116.00 | $232.00 | not published | 0 |
| Radiation physics consult CPT 77336 | $478.00 | $956.00 | $133.76 – $137.70 | 4 |
| Radiation therapy dose plan CPT 77300 | $265.00 | $530.00 | $133.76 – $137.70 | 4 |
| Radiation therapy management CPT 77431 | $415.00 | $830.00 | not published | 0 |
| Radiation treatment aid(s) CPT 77332 | $246.50 | $493.00 | $133.76 – $137.70 | 4 |
| Radiation treatment aid(s) CPT 77333 | $432.00 | $864.00 | $133.76 – $137.70 | 4 |
| Radiation treatment aid(s) CPT 77334 | $587.00 | $1,174.00 | $372.63 – $383.59 | 4 |
| Radiation treatment delivery CPT 77402 | $316.00 | $632.00 | not published | 0 |
| Radiation treatment delivery CPT 77412 | $493.00 | $986.00 | $549.89 – $566.06 | 4 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $1,547.00 – $5,980.00 | 2 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Radical resection of elbow CPT 24149 | not published | not published | $3,338.00 – $8,246.00 | 5 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $4,007.00 – $13,397.00 | 5 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $2,670.00 – $5,418.00 | 6 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $2,890.77 – $6,716.00 | 6 |
| Radiesse injection HCPCS Q2026 | not published | not published | $356.17 – $366.65 | 4 |
| Radiology port images(s) CPT 77417 | $122.50 | $245.00 | not published | 0 |
| Radiotherapy dose plan imrt CPT 77301 | $4,080.00 | $8,160.00 | $1,377.48 – $1,418.00 | 4 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $175.67 – $180.83 | 4 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,450.00 | $4,900.00 | $540.36 – $556.26 | 4 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,450.00 | $4,900.00 | $540.36 – $556.26 | 4 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $1,670.50 | $3,341.00 | $1,288.43 – $1,326.33 | 4 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,450.00 | $4,900.00 | $540.36 – $556.26 | 4 |
| Radphm lcl tumor plr sgl day CPT 78800 | $544.50 | $1,089.00 | $397.85 – $409.55 | 4 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $2,890.77 – $3,895.00 | 6 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $2,890.77 – $6,716.00 | 6 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $2,890.77 – $3,895.00 | 6 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $2,890.77 – $3,895.00 | 6 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $2,890.77 – $6,716.00 | 6 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $2,890.77 – $3,895.00 | 6 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $2,890.77 – $6,716.00 | 6 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $2,670.00 – $3,276.00 | 5 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $75.85 – $78.08 | 4 |
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.