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 50 mg/mL Soln 10 mL VIAL
Rapids, MN
See all hospitals reporting HCPCS J0133 →Price type
Allina Health Systems’s median price of $35 is 619% above the median hospital's median price ($5), higher than 72% of the 2,202 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare united healthcare (um) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Bcbs Mn bc premier (m u) facility · other · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Bcbs Mn bc state health plan (mu) facility · other · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Blue Cross Blue Shield bc aehp (mu) facility · other · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Bcbs Mn bc high value/performance network (mu) facility · other · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $11 | $15 | $8 | 52% | — | $10 – $33 |
| 8 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $13 | $16 | $8 | 52% | — | $12 – $36 |
| 9 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $20 | $25 | $13 | 52% | — | $18 – $58 |
| 10 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $21 | $27 | $14 | 52% | — | $20 – $62 |
| 11 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $25 | $32 | $17 | 52% | — | $23 – $73 |
| 12 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $31 | $39 | $21 | 52% | — | $28 – $90 |
| 13 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $33 | $42 | $22 | 52% | — | $31 – $96 |
| 14 | Medica medica ubh (m) facility · percent of total billed charges · inpatientfrom % of charges | $40 | $50 | $26 | 52% | — | $36 – $115 |
| 15 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $41 | $52 | $27 | 52% | — | $37 – $118 |
| 16 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $43 | $54 | $28 | 52% | — | $39 – $123 |
| 17 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $43 | $54 | $28 | 52% | — | $39 – $123 |
| 18 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $45 | $57 | $30 | 52% | — | $41 – $129 |
| 19 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $45 | $58 | $30 | 52% | — | $42 – $131 |
| 20 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $48 | $61 | $32 | 52% | — | $44 – $138 |
| 21 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $48 | $61 | $32 | 52% | — | $44 – $138 |
| 22 | Medica medica ubh (m) facility · percent of total billed charges · outpatientfrom % of charges | $48 | $61 | $32 | 52% | — | $44 – $138 |
Last updated: Jun 17, 2026
See Acyclovir intravenous antiviral solution pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.