Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
ACYCLOVIR SODIUM 50 MG/ML IV SOLN
Low
$0
Average
$53
Median
$21
High
$3.6k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1527 hospitals; the 90th percentile is 1610.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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2,265 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Wayne Hospital Company Greenville, OH percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | 65 | $8 – $8 |
| 2 | DIGNITY COMMUNITY CARE Sacramento, CA fee schedule · outpatient | 3 | $0 | $0 | — | — | 21–210 | $0 – $0 |
| 3 | DIGNITY HEALTH Folsom, CA fee schedule · outpatient | 3 | $0 | $0 | — | — | 21–210 | $0 – $0 |
| 4 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA percent of total billed charges · bothfrom % of charges | 1 | $85 | $81 | $48 | 59% | 20 | $29 – $154 |
| 5 | Virtua_Our_Lady_of_Lourdes_Inc Camden, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $19 | — | — | 13 | $19 – $19 |
| 6 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | 13–130 | $22 – $22 |
| 7 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | 13–130 | $22 – $22 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 2 | $6 | $19 | $22 | 117% | 12–120 | $0 – $65 |
| 9 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 2 | $6 | $10 | $10 | 101% | 12–120 | $0 – $30 |
| 10 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | — | — | 12 | $59 – $59 |
| 11 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY percent of total billed charges · outpatientfrom % of charges | 3 | $7 | $8 | $7 | 81% | 6–60 | $0 – $23 |
| 12 | HCA FLORIDA NORTHWEST HOSPITAL MARGATE, FL percent of total billed charges · outpatientfrom % of charges | 4 | $138 | $258 | $271 | 105% | 2–20 | $35 – $721 |
| 13 | Northern Hospital District of Surry County Mount Airy, NC facility · percent of total billed charges · bothfrom % of charges | 1 | $6 | $6 | — | — | 2–20 | $6 – $6 |
| 14 | Springhill Memorial Hospital Mobile, AL other · outpatient | 2 | $1 | $1 | — | — | 2–20 | $1 – $1 |
| 15 | Appalachian Regional Healthcare, Inc. Hinton, WV percent of total billed charges · bothfrom % of charges | 1 | $55 | $55 | — | — | 1–10 | $55 – $55 |
| 16 | HCA FLORIDA JFK HOSPITAL ATLANTIS, FL percent of total billed charges · outpatientfrom % of charges | 3 | $322 | $1.1k | $1.2k | 115% | 1–10 | $74 – $2.8k |
| 17 | HCA FLORIDA MERCY HOSPITAL MIAMI, FL percent of total billed charges · outpatientfrom % of charges | 3 | $205 | $194 | $116 | 60% | 1–10 | $47 – $330 |
| 18 | HCA FLORIDA NORTH FLORIDA HOSPITAL GAINESVILLE, FL percent of total billed charges · outpatientfrom % of charges | 3 | $9 | $84 | $140 | 167% | 1–10 | $1 – $416 |
| 19 | HCA FLORIDA ORANGE PARK HOSPITAL ORANGE PARK, FL percent of total billed charges · outpatientfrom % of charges | 2 | $167 | $167 | $3 | 2% | 1–10 | $163 – $170 |
| 20 | HCA FLORIDA POINCIANA HOSPITAL Kissimmee, FL percent of total billed charges · outpatientfrom % of charges | 3 | $2 | $7 | $9 | 121% | 1–10 | $0 – $20 |
| 21 | HCA FLORIDA ST. PETERSBURG HOSPITAL ST. PETERSBURG, FL percent of total billed charges · outpatientfrom % of charges | 3 | $514 | $397 | $192 | 48% | 1–10 | $126 – $549 |
| 22 | HCA FLORIDA WOODMONT HOSPITAL TAMARAC, FL percent of total billed charges · outpatientfrom % of charges | 3 | $21 | $55 | $68 | 124% | 1–10 | $0 – $189 |
| 23 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 24 | NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA percent of total billed charges · outpatientfrom % of charges | 2 | $11 | $11 | — | — | 1–10 | $11 – $11 |
| 25 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 1 | $157 | $157 | — | — | 1–10 | $157 – $157 |
← Payers reporting HCPCS J0133 · Snapshot 20261111T120946Z-9134e7f7