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
River Falls, WI
See all hospitals reporting HCPCS J0133 →Price type
Allina Health Systems’s median price of $37 is 638% above the median hospital's median price ($5), higher than 73% of the 2,220 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: 6 payers, 17 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn bc pmap (r) facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Bcbs Mn bc premier (r) facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Blue Cross Blue Shield bc aehp (r) facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Bcbs Mn bc state health plan (r) facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $11 | $17 | $9 | 52% | — | $10 – $33 |
| 6 | Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $15 | $22 | $11 | 52% | — | $14 – $44 |
| 7 | Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient | $25 | $37 | $19 | 52% | — | $23 – $73 |
| 8 | Medica medica medicare (r) facility · fee schedule · outpatient | $25 | $37 | $19 | 52% | — | $23 – $73 |
| 9 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $26 | $37 | $19 | 52% | — | $23 – $74 |
| 10 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $35 | $50 | $26 | 52% | — | $32 – $101 |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $35 | $51 | $26 | 52% | — | $32 – $102 |
| 12 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $38 | $55 | $28 | 52% | — | $34 – $109 |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $38 | $55 | $28 | 52% | — | $35 – $110 |
| 14 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $48 | $69 | $36 | 52% | — | $44 – $138 |
| 15 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $48 | $69 | $36 | 52% | — | $44 – $138 |
| 16 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $48 | $70 | $36 | 52% | — | $44 – $139 |
| 17 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $49 | $70 | $36 | 52% | — | $44 – $140 |
Last updated: Jun 15, 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.