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 |
|---|---|---|---|---|
| Salpingostomy 58770 CPT 58770 | not published | not published | $3,221.58 – $5,978.00 | 5 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $132.50 – $136.39 | 4 |
| Sargramostim injection HCPCS J2820 | not published | not published | $51.37 – $52.88 | 4 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $50.66 – $54.00 | 5 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $305.31 – $305.31 | 1 |
| Sarscov coronavirus ag ia CPT 87426 | $17.66 | $35.33 | $36.04 – $54.43 | 5 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $32.00 | $64.00 | $71.70 – $88.34 | 5 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $4,007.00 – $8,246.00 | 6 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $877.50 | $1,755.00 | $237.46 – $244.44 | 4 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $611.00 | $1,222.00 | $104.04 – $107.10 | 4 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $728.50 | $1,457.00 | $237.46 – $244.44 | 4 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $219.50 | $439.00 | $104.04 – $107.10 | 4 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $482.00 | $964.00 | $104.04 – $107.10 | 4 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $662.50 | $1,325.00 | $104.04 – $107.10 | 4 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,007.00 | $2,014.00 | $237.46 – $244.44 | 4 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $686.00 | $1,372.00 | $104.04 – $107.10 | 4 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $692.50 | $1,385.00 | $104.04 – $107.10 | 4 |
| Scan proc cranial extra CPT 61782 | not published | not published | $511.00 – $2,004.00 | 2 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $511.00 – $2,004.00 | 2 |
| Scan proc spinal CPT 61783 | not published | not published | $511.00 – $2,004.00 | 2 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $2,138.00 | $4,276.00 | $1,547.00 – $5,418.00 | 6 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $3,256.29 – $6,716.00 | 6 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $18.91 – $19.47 | 5 |
| Scr c/v cyto,autosys and md HCPCS G0141 | not published | not published | $26.83 – $102.94 | 2 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $25.48 – $33.54 | 5 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $35.82 – $46.17 | 5 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $62.50 | $125.00 | $27.02 – $44.41 | 5 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $27.59 – $33.97 | 5 |
| Screen cerv/vag thin layer HCPCS G0123 | $62.50 | $125.00 | $20.67 – $33.97 | 5 |
| Screen c/v thin layer by md HCPCS G0124 | not published | not published | $26.83 – $102.94 | 2 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $925.49 – $1,571.00 | 6 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $925.49 – $1,571.00 | 6 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $76.50 | $153.00 | $18.41 – $26.66 | 5 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $28.84 – $41.88 | 5 |
| Screening hepatitis c antibody high risk HCPCS G0472 | not published | not published | $23.33 – $48.67 | 5 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $96.50 | $193.00 | $24.56 – $39.64 | 5 |
| Screening Mammogram CPT 77067 | $307.50 | $615.00 | $91.33 – $94.02 | 4 |
| Screening pap smear by phys HCPCS P3001 | not published | not published | $26.83 – $79.56 | 2 |
| Screening prostate cancer PSA HCPCS G0103 | $84.50 | $169.00 | $19.70 – $30.84 | 5 |
| Screen pap by tech w md supv HCPCS P3000 | $62.50 | $125.00 | $17.71 – $19.47 | 5 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $4,560.00 | $9,120.00 | not published | 0 |
| Sc ther infusion reset pump CPT 96371 | $206.50 | $413.00 | $71.65 – $73.76 | 4 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $1,367.50 | $2,735.00 | $511.00 – $2,004.00 | 2 |
| Sedimentation rate erythrocyte automated CPT 85652 | $14.00 | $28.00 | $2.75 – $4.52 | 5 |
| Seg acet and eth estr yearly HCPCS J7294 | not published | not published | $6,542.74 – $6,542.74 | 1 |
| Segmentectomy 32484 CPT 32484 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Select picture audiometry CPT 92583 | $111.00 | $222.00 | $58.71 – $60.44 | 4 |
| Self-adher band w>=3" <5"/yd HCPCS A6454 | $7.76 | $15.53 | not published | 0 |
| Semen analysis HCPCS G0027 | not published | not published | $6.63 – $10.91 | 5 |
| Semen analysis presence/motility CPT 89321 | $69.50 | $139.00 | $12.29 – $20.21 | 5 |
| Semen analysis w/count CPT 89310 | not published | not published | $8.78 – $14.44 | 5 |
| Sensorimotor examination CPT 92060 | not published | not published | $58.71 – $60.44 | 4 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $37.17 – $38.26 | 4 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $2,366.07 – $5,978.00 | 6 |
| Sept9 promoter methylation analysis CPT 81327 | $173.50 | $347.00 | $100.40 – $201.60 | 5 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Serpina1 gene CPT 81332 | $322.00 | $644.00 | $44.52 – $71.46 | 5 |
| Sertraline (zoloft) - sendout CPT 80332 | not published | not published | $0.03 – $29.64 | 2 |
| Set radiation therapy field CPT 77280 | $590.00 | $1,180.00 | $133.76 – $137.70 | 4 |
| Set radiation therapy field CPT 77285 | $956.00 | $1,912.00 | $372.63 – $383.59 | 4 |
| Set radiation therapy field CPT 77290 | $1,123.00 | $2,246.00 | $372.63 – $383.59 | 4 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | $305.66 – $511.00 | 5 |
| Sever cranial nerve CPT 64771 | not published | not published | $1,571.00 – $5,978.00 | 6 |
| Sewhfo airplane without jnts cf HCPCS L3976 | $811.44 | $1,622.88 | not published | 0 |
| Sewhfo airplane w/jnt(s) cf HCPCS L3978 | $1,090.89 | $2,181.78 | not published | 0 |
| Sewhfo cap desgn w/jnt(s) cf HCPCS L3977 | $351.38 | $702.77 | not published | 0 |
| Sewhfo cap design without jnt cf HCPCS L3975 | $811.44 | $1,622.88 | not published | 0 |
| Sewho airplane without jnts cf HCPCS L3967 | $1,090.89 | $2,181.78 | not published | 0 |
| Sewho airplane w/jnt(s) cf HCPCS L3973 | $957.90 | $1,915.79 | not published | 0 |
| Sewho cap design without jnts cf HCPCS L3961 | $701.22 | $1,402.43 | not published | 0 |
| Sewho cap design w/jnt(s) cf HCPCS L3971 | $909.25 | $1,818.50 | not published | 0 |
| Sex chromatin identification CPT 88130 | not published | not published | $18.34 – $25.22 | 5 |
| Sex chromatin identification CPT 88140 | not published | not published | $8.15 – $13.40 | 5 |
| Sex transformation f to m CPT 55980 | not published | not published | $3,508.06 – $3,611.23 | 4 |
| Sex transformation m to f CPT 55970 | not published | not published | $4,978.43 – $5,124.85 | 4 |
| Sf3b1 gene common variants CPT 81347 | not published | not published | $197.12 – $231.90 | 5 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $1,190.90 – $4,314.00 | 6 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $206.50 | $413.00 | $199.67 – $2,845.00 | 6 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $247.00 | $494.00 | $199.67 – $2,845.00 | 6 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $371.00 | $742.00 | $404.56 – $2,845.00 | 6 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $404.56 – $2,845.00 | 6 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $181.00 | $362.00 | $199.67 – $2,845.00 | 6 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $223.00 | $446.00 | $199.67 – $2,845.00 | 6 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $261.00 | $522.00 | $199.67 – $2,845.00 | 6 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | $263.50 | $527.00 | $404.56 – $2,845.00 | 6 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $309.00 | $618.00 | $404.56 – $2,845.00 | 6 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $217.50 | $435.00 | $199.67 – $2,845.00 | 6 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $256.00 | $512.00 | $199.67 – $2,845.00 | 6 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $2,498.49 | $4,996.98 | not published | 0 |
| Shigella antibody CPT 86771 | not published | not published | $22.12 – $25.70 | 5 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $3,304.00 – $13,397.00 | 6 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $3,256.29 – $13,397.00 | 6 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $3,256.29 – $13,397.00 | 6 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $3,304.00 – $13,397.00 | 6 |
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.