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 |
|---|---|---|---|---|
| Assay of corticosterone CPT 82528 | not published | not published | $22.97 – $37.74 | 5 |
| Assay of digoxin free CPT 80163 | not published | not published | $13.55 – $21.68 | 5 |
| Assay of endocrine hormone CPT 84235 | not published | not published | $72.65 – $87.74 | 5 |
| Assay of estrogen CPT 84233 | not published | not published | $89.64 – $107.99 | 5 |
| Assay of etiocholanolone CPT 82696 | not published | not published | $26.76 – $39.54 | 5 |
| Assay of feces for trypsin CPT 84490 | not published | not published | $10.13 – $12.76 | 5 |
| Assay of feces porphyrins CPT 84126 | not published | not published | $0.03 – $42.71 | 5 |
| Assay of feces/urobilinogen CPT 84577 | not published | not published | $17.14 – $20.92 | 5 |
| Assay of fluoride CPT 82735 | not published | not published | $18.91 – $31.09 | 5 |
| Assay of galactose CPT 82760 | not published | not published | $11.42 – $18.77 | 5 |
| Assay of gdh enzyme CPT 82965 | not published | not published | $12.96 – $13.81 | 5 |
| Assay of glucosidase CPT 82963 | not published | not published | $21.91 – $36.01 | 5 |
| Assay of glutathione CPT 82978 | $66.00 | $132.00 | $15.76 – $23.89 | 5 |
| Assay of haptoglobins CPT 83012 | not published | not published | $27.43 – $28.82 | 5 |
| Assay of idh enzyme CPT 83570 | not published | not published | $9.03 – $14.83 | 5 |
| Assay of interleukin-6 (il-6) CPT 83529 | $60.00 | $120.00 | $17.62 – $20.72 | 5 |
| Assay of intrinsic factor CPT 83528 | not published | not published | $20.22 – $26.66 | 5 |
| Assay of lap enzyme CPT 83670 | $43.00 | $86.00 | $10.01 – $15.36 | 5 |
| Assay of leflunomide CPT 80193 | $62.00 | $124.00 | $39.34 – $46.28 | 5 |
| Assay of lrh hormone CPT 83727 | not published | not published | $17.53 – $28.82 | 5 |
| Assay of methemalbumin CPT 83857 | not published | not published | $10.95 – $18.01 | 5 |
| Assay of neonatal thyroxine CPT 84437 | not published | not published | $6.60 – $10.85 | 5 |
| Assay of osteocalcin CPT 83937 | $116.00 | $232.00 | $30.45 – $50.05 | 5 |
| Assay of phenylketones CPT 84035 | not published | not published | $4.06 – $6.13 | 5 |
| Assay of pregnanediol CPT 84135 | not published | not published | $21.70 – $32.08 | 5 |
| Assay of pregnanetriol CPT 84138 | not published | not published | $21.47 – $31.75 | 5 |
| Assay of procainamide CPT 80190 | not published | not published | $28.09 – $63.00 | 5 |
| Assay of procainamide w/metab CPT 80192 | $31.00 | $62.00 | $17.08 – $28.09 | 5 |
| Assay of progesterone CPT 84234 | not published | not published | $66.18 – $108.77 | 5 |
| Assay of prostaglandin CPT 84150 | $218.50 | $437.00 | $41.86 – $43.86 | 5 |
| Assay of PSA complexed CPT 84152 | not published | not published | $18.76 – $30.84 | 5 |
| Assay of quinine CPT 84228 | not published | not published | $11.86 – $19.51 | 5 |
| Assay of rbc pg6d enzyme CPT 84085 | not published | not published | $9.63 – $11.30 | 5 |
| Assay of salicylate CPT 80179 | $194.50 | $389.00 | $19.01 – $22.37 | 5 |
| Assay of semen fructose CPT 82757 | not published | not published | $17.69 – $29.09 | 5 |
| Assay of sialic acid CPT 84275 | $62.00 | $124.00 | $13.71 – $22.52 | 5 |
| Assay of silica CPT 84285 | not published | not published | $25.71 – $39.48 | 5 |
| Assay of somatostatin CPT 84307 | $84.00 | $168.00 | $18.65 – $30.65 | 5 |
| Assay of thiocyanate CPT 84430 | $54.00 | $108.00 | $11.86 – $19.51 | 5 |
| Assay of troponin qual CPT 84512 | not published | not published | $10.29 – $12.91 | 5 |
| Assay of tyrosine CPT 84510 | not published | not published | $10.84 – $17.44 | 5 |
| Assay of urine sulfate CPT 84392 | $22.00 | $44.00 | $5.60 – $7.97 | 5 |
| Assay of urine urobilinogen CPT 84580 | not published | not published | $9.74 – $11.90 | 5 |
| Assay of urine urobilinogen CPT 84583 | not published | not published | $6.17 – $8.42 | 5 |
| Assay phosphatidylglycerol CPT 84081 | not published | not published | $16.85 – $27.71 | 5 |
| Assay phosphohexose enzymes CPT 84087 | not published | not published | $10.94 – $17.30 | 5 |
| Assay rbc glutathione CPT 82979 | not published | not published | $9.63 – $11.54 | 5 |
| Assay toxin or antitoxin CPT 87230 | $10.00 | $20.00 | $20.13 – $33.11 | 5 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $208.50 | $417.00 | $98.00 – $100.88 | 4 |
| Assess cyst contrast inject CPT 49424 | $183.50 | $367.00 | $511.00 – $2,004.00 | 2 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $23.00 | $46.00 | $4.36 – $7.15 | 5 |
| Asses tinnit/pitch/loud/match/mask 92625 CPT 92625 | not published | not published | $128.06 – $131.82 | 4 |
| Assist-bilat spinal disk surgery add-on 63035 CPT 63035 | not published | not published | $511.00 – $4,007.00 | 2 |
| Assistive tech assessment, ot CPT 97755 | not published | not published | $38.11 – $39.23 | 4 |
| Assist oocyte fertilization CPT 89280 | not published | not published | $52.48 – $825.39 | 5 |
| Assist oocyte fertilization CPT 89281 | not published | not published | $52.48 – $174.54 | 5 |
| Ast/sgot CPT 84450 | $24.50 | $49.00 | $5.28 – $8.66 | 5 |
| Asxl1 full gene sequence CPT 81175 | not published | not published | $690.03 – $848.42 | 5 |
| Asxl1 gene target seq alys CPT 81176 | not published | not published | $246.74 – $358.37 | 5 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | not published | not published | $93.17 – $95.91 | 4 |
| Athletic trn eval high cmplx CPT 97171 | $228.50 | $457.00 | not published | 0 |
| Athletic trn eval low cmplx CPT 97169 | $164.00 | $328.00 | not published | 0 |
| Athletic trn eval mod cmplx CPT 97170 | $207.50 | $415.00 | not published | 0 |
| Athletic trn re-eval plan cr CPT 97172 | $75.00 | $150.00 | not published | 0 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $17,271.50 | $34,543.00 | $3,338.00 – $29,725.00 | 2 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $17,271.50 | $34,543.00 | $3,338.00 – $29,725.00 | 2 |
| Atn1 gene detc abnor alleles CPT 81177 | not published | not published | $139.74 – $164.40 | 5 |
| Atomic absorption CPT 82190 | not published | not published | $16.22 – $25.00 | 5 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | not published | not published | $0.29 – $0.29 | 1 |
| Attach bladder/urethra comp 51841 CPT 51841 | not published | not published | $5,978.00 – $5,980.00 | 2 |
| Attach bladder/urethra simple 51840 CPT 51840 | not published | not published | $4,978.43 – $5,978.00 | 5 |
| Attach ocular implant CPT 65140 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | $24.00 | $48.00 | not published | 0 |
| Atxn10 gene detc abnor allel CPT 81183 | not published | not published | $139.74 – $164.40 | 5 |
| Atxn1 gene detc abnor allele CPT 81178 | not published | not published | $139.74 – $164.40 | 5 |
| Atxn2 gene detc abnor allele CPT 81179 | not published | not published | $139.74 – $164.40 | 5 |
| Atxn3 gene detc abnor allele CPT 81180 | not published | not published | $139.74 – $164.40 | 5 |
| Atxn7 gene detc abnor allele CPT 81181 | not published | not published | $139.74 – $164.40 | 5 |
| Atxn8os gen detc abnor allel CPT 81182 | not published | not published | $139.74 – $164.40 | 5 |
| Aud brainstem implt programg CPT 92640 | not published | not published | $128.06 – $131.82 | 4 |
| Audiometry air + bone CPT 92553 | $172.50 | $345.00 | $128.06 – $131.82 | 4 |
| Auditory function + 15 min CPT 92621 | $54.00 | $108.00 | not published | 0 |
| Auditory function 60 min CPT 92620 | $203.00 | $406.00 | $128.06 – $131.82 | 4 |
| Aud rehab pre-ling hear loss CPT 92630 | $172.50 | $345.00 | not published | 0 |
| Augmentation cheek bone CPT 21270 | not published | not published | $4,007.00 – $10,995.00 | 6 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $5,418.00 – $6,050.24 | 6 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $4,339.00 – $10,995.00 | 6 |
| Augmentation of facial bones CPT 21208 | not published | not published | $5,418.00 – $10,995.00 | 6 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $1,611.00 | $3,222.00 | $511.00 – $2,004.00 | 2 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $9,031.00 | $18,062.00 | $4,007.00 – $13,397.00 | 5 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $3,304.00 – $13,397.00 | 5 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $3,304.00 – $13,397.00 | 5 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | $502.00 | $1,004.00 | $708.73 – $882.68 | 5 |
| Autologous blood op salvage CPT 86891 | not published | not published | $16.50 – $823.43 | 5 |
| Autologous blood process CPT 86890 | $707.00 | $1,414.00 | $64.18 – $174.54 | 5 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $2,053.37 – $2,113.77 | 4 |
| Automated diff wbc count CPT 85004 | not published | not published | $6.60 – $10.85 | 5 |
| Autonomic nrv adrenrg inervj CPT 95922 | $246.50 | $493.00 | $132.41 – $136.30 | 4 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $128.06 – $131.82 | 4 |
| Autonomic nrv syst funj test CPT 95923 | $289.00 | $578.00 | $132.41 – $136.30 | 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.