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
$63
Median
$5
High
$8.8k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
1048 hospitals; the 90th percentile is 1660.8× 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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1,403 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Missouri Baptist Medical Center Saint Louis, MO fee schedule · both | 2 | $40 | $40 | $24 | 60% | 540 | $16 – $64 |
| 2 | Barnes Jewish Hospital St. Louis, MO fee schedule · both | 2 | $65 | $65 | $3 | 4% | 119 | $63 – $68 |
| 3 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 5 | $36 | $39 | $5 | 13% | 60 | $36 – $49 |
| 4 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 2 | $71 | $71 | $14 | 19% | 46 | $58 – $85 |
| 5 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 2 | $71 | $71 | $14 | 19% | 25 | $58 – $85 |
| 6 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 6 | $28 | $33 | $9 | 27% | 13 | $25 – $48 |
| 7 | Fauquier Health Warrenton, VA facility · percent of total billed charges · outpatientfrom % of charges | 6 | $416 | $416 | — | — | 6–60 | $416 – $416 |
| 8 | Clinch Valley Health Richlands, VA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $0 | $0 | — | — | 3–30 | $0 – $0 |
| 9 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $119 | $119 | — | — | 2–20 | $119 – $119 |
| 10 | Brunswick Community Hospital, LLC Bolivia, NC percent of total billed charges · outpatientfrom % of charges | 2 | $93 | $93 | — | — | 2–20 | $93 – $93 |
| 11 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 4 | $0 | $0 | — | — | 2–20 | $0 – $0 |
| 12 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 4 | $0 | $0 | — | — | 2–20 | $0 – $0 |
| 13 | DIGNITY HEALTH Gilbert, AZ fee schedule · outpatient | 4 | $0 | $0 | — | — | 2–20 | $0 – $0 |
| 14 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $71 | $71 | — | — | 2–20 | $71 – $71 |
| 15 | Lake Regional Health System Osage Beach, MO percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | 2–20 | $1 – $1 |
| 16 | Person Memorial Hospital Roxboro, NC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $25 | $25 | — | — | 2–20 | $25 – $25 |
| 17 | ST. ALEXIUS MEDICAL CENTER Bismarck, ND fee schedule · outpatient | 2 | $0 | $0 | — | — | 2–20 | $0 – $0 |
| 18 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 1 | $269 | $269 | — | — | 2–20 | $269 – $269 |
| 19 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $0 | $0 | $0 | 20% | 1–10 | $0 – $0 |
| 20 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $0 | $0 | $0 | 20% | 1–10 | $0 – $0 |
| 21 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 2 | $0 | $0 | $0 | 20% | 1–10 | $0 – $0 |
| 22 | Cumberland County Hospital System Inc Fayetteville, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $79 | $79 | — | — | 1–10 | $79 – $79 |
| 23 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 10 | $57 | $50 | $17 | 33% | 1–10 | $13 – $61 |
| 24 | Monroe County Hospital Forsyth, GA other · outpatient | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 25 | Monroe County Hospital Forsyth, GA percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $14 | $6 | 44% | 1–10 | $10 – $23 |
← Payers reporting HCPCS J0133 · Snapshot 20261111T120946Z-9134e7f7