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 |
|---|---|---|---|---|
| Svc venogram s&i CPT 75827 | $1,622.50 | $3,245.00 | $1,566.60 – $1,612.67 | 4 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $6.96 – $53.26 | 5 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,571.00 – $3,276.00 | 6 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $1,943.35 – $5,978.00 | 5 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $1,571.00 – $8,246.00 | 6 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $24.78 – $25.15 | 2 |
| Synthetic sentence id test CPT 92576 | not published | not published | $37.17 – $38.26 | 4 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $8.11 – $8.35 | 4 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $20.00 | $40.00 | $4.49 – $7.39 | 5 |
| System cardiomems hosp electronics HCPCS C2624 | $13,118.62 | $26,237.25 | not published | 0 |
| System pacing micra av HCPCS C1786 | $7,044.00 | $14,088.00 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $7,262.60 | $14,525.19 | not published | 0 |
| System sealant biosentry tract HCPCS C2613 | $358.63 | $717.26 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $74.50 | $149.00 | $17.28 – $28.40 | 5 |
| T3 (triiodothyronine) total CPT 84480 | $63.50 | $127.00 | $14.46 – $23.77 | 5 |
| T4 (thyroxine) free CPT 84439 | $42.00 | $84.00 | $9.20 – $15.12 | 5 |
| T4 (thyroxine) total CPT 84436 | $33.00 | $66.00 | $7.01 – $11.53 | 5 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $1.59 – $1.59 | 1 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $5.01 – $5.01 | 1 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.48 – $0.48 | 1 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $268.41 – $276.31 | 4 |
| Tacrolimus therapeutic drug level CPT 80197 | $82.00 | $164.00 | $14.00 – $23.00 | 5 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $14.60 – $15.03 | 4 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $1,547.00 – $5,980.00 | 2 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $75.41 – $77.63 | 4 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $74.07 – $76.25 | 4 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $511.00 – $2,670.00 | 2 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $511.00 – $2,670.00 | 2 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,342.00 | $4,684.00 | $774.72 – $797.51 | 5 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,977.99 – $3,503.52 | 5 |
| Target gsa panel organ neop CPT 81445 | $1,119.00 | $2,238.00 | $609.87 – $717.49 | 5 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,595.93 – $1,642.87 | 4 |
| Tas congenital car anomal CPT 33741 | $2,554.50 | $5,109.00 | $1,547.00 – $1,547.00 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $511.00 – $2,845.00 | 6 |
| Tavr perq femoral CPT 33361 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.29 – $0.29 | 4 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $139.74 – $164.40 | 5 |
| Tbs techl calculation only CPT 77091 | not published | not published | $86.61 – $89.15 | 4 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $86.61 – $89.15 | 4 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $102.00 – $105.00 | 5 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $261.50 | $523.00 | $63.22 – $103.91 | 5 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $1,529.97 – $1,529.97 | 1 |
| Tc-99m bicisate HCPCS A9557 | $1,695.50 | $3,391.00 | $791.03 – $814.30 | 4 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $1,132.00 | $2,264.00 | $952.81 – $980.84 | 4 |
| Tc-99m exametazime diag HCPCS A9521 | $1,132.00 | $2,264.00 | $946.26 – $974.10 | 4 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $335.17 – $345.03 | 4 |
| Tc-99m labeled rbc HCPCS A9560 | $219.00 | $438.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $197.00 | $394.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $96.50 | $193.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $58.50 | $117.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $341.50 | $683.00 | not published | 0 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $6.00 | $12.00 | $18.90 – $18.90 | 1 |
| Tc-99m oxidronate HCPCS A9561 | $35.00 | $70.00 | not published | 0 |
| Tc-99m pentetate dtpa HCPCS A9539 | $166.00 | $332.00 | not published | 0 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $191.50 | $383.00 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $43.00 | $86.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $73.50 | $147.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $183.50 | $367.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $358.00 | $716.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $78.00 | $156.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $159.00 | $318.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $657.00 | $1,314.00 | not published | 0 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $511.00 – $2,845.00 | 6 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $104.04 – $107.10 | 4 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $104.04 – $107.10 | 4 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $439.06 – $1,010.00 | 6 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $206.50 | $413.00 | $47.92 – $78.78 | 5 |
| T cells absolute cd 4 count CPT 86361 | $112.50 | $225.00 | $27.32 – $44.89 | 5 |
| T cells total count CPT 86359 | $167.00 | $334.00 | $38.48 – $63.24 | 5 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $214.89 – $221.21 | 4 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $214.89 – $221.21 | 4 |
| Tcran magn stim redetemine CPT 90869 | $620.50 | $1,241.00 | $214.89 – $221.21 | 4 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $1,547.00 – $1,547.00 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $221.43 – $227.94 | 4 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $780.16 – $803.10 | 4 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $780.16 – $803.10 | 4 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.26 – $7.47 | 4 |
| Telethx isodose plan cplx CPT 77307 | $847.00 | $1,694.00 | $372.63 – $383.59 | 4 |
| Telethx isodose plan simple CPT 77306 | $608.00 | $1,216.00 | $372.63 – $383.59 | 4 |
| Temozolomide HCPCS J8700 | not published | not published | $0.74 – $0.74 | 1 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $10.60 – $10.91 | 4 |
| Temperature gradient studies CPT 93740 | not published | not published | $128.06 – $131.82 | 4 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $27.25 – $28.05 | 4 |
| Tendon lengthening CPT 26476 | not published | not published | $1,010.00 – $3,344.08 | 6 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Tendon shortening CPT 26477 | not published | not published | $1,010.00 – $3,344.08 | 6 |
| Tendon transfer with graft CPT 26492 | not published | not published | $3,256.29 – $8,246.00 | 6 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $175.67 – $180.83 | 4 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $3,304.00 – $10,995.00 | 6 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $3,256.29 – $3,895.00 | 6 |
| Tenolysis triceps CPT 24332 | not published | not published | $2,670.00 – $8,246.00 | 6 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $3,304.00 – $8,246.00 | 6 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,600.27 – $3,895.00 | 6 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $3,256.29 – $13,397.00 | 5 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $1,571.00 – $5,978.00 | 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.