Acyclovir intravenous antiviral solution at Astera Health

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.

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Provider: anthropic
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Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ACYCLOVIR SODIUM 50 MG/ML IV SOLN

Wadena, MN

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Pricing by billing methodology

Price type

How this price compares nationally

Astera Health’s median price of $92 is 1796% above the median hospital's median price ($5), higher than 92% of the 2,198 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0133 at Astera Health

Negotiated rates from the hospital’s own file: 7 payers, 34 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	Blue Cross Blue Shield bcbs federal employees [400004] fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
2	Blue Cross Blue Shield bcbs high value network fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
3	Blue Cross Blue Shield blue plus [400058] fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
4	Ucare ucare pmap [300063] percent of total billed charges · outpatientfrom % of charges	$45	$45	—	—	—	$45 – $45
5	Blue Cross Blue Shield mr-bcbs mn [400069] percent of total billed charges · outpatientfrom % of charges	$49	$49	—	—	—	$49 – $49
6	Medica mr-medica advantage solutions [100895] percent of total billed charges · outpatientfrom % of charges	$49	$49	—	—	—	$49 – $49
7	Ucare mr-ucare [300064] percent of total billed charges · outpatientfrom % of charges	$52	$52	—	—	—	$52 – $52
8	Ucare mr-ucare msho [300061] percent of total billed charges · outpatientfrom % of charges	$52	$52	—	—	—	$52 – $52
9	Medica medica mncare [100751] percent of total billed charges · outpatientfrom % of charges	$53	$53	—	—	—	$53 – $53
10	Medica medica pmap [100345] percent of total billed charges · outpatientfrom % of charges	$53	$53	—	—	—	$53 – $53
11	Medica mr-medica dual solutions msho [100344] percent of total billed charges · outpatientfrom % of charges	$69	$69	—	—	—	$69 – $69
12	Medica mr-medica dual solutions msho [100344] percent of total billed charges · inpatientfrom % of charges	$71	$71	—	—	—	$71 – $71
13	Ucare ucare commercial [100748] percent of total billed charges · inpatientfrom % of charges	$86	$86	—	—	—	$86 – $86
14	UnitedHealthcare united healthcare [100453] percent of total billed charges · inpatientfrom % of charges	$92	$92	—	—	—	$92 – $92
15	Ucare ucare commercial [100748] percent of total billed charges · outpatientfrom % of charges	$92	$92	—	—	—	$92 – $92
16	Blue Cross Blue Shield bcbs federal employees [400004] percent of total billed charges · inpatientfrom % of charges	$94	$94	—	—	—	$94 – $94
17	Blue Cross Blue Shield bcbs high value network percent of total billed charges · inpatientfrom % of charges	$94	$94	—	—	—	$94 – $94
18	Blue Cross Blue Shield blue plus [400058] percent of total billed charges · inpatientfrom % of charges	$94	$94	—	—	—	$94 – $94
19	UnitedHealthcare united healthcare [100453] percent of total billed charges · outpatientfrom % of charges	$96	$96	—	—	—	$96 – $96
20	Medica medica [100341] percent of total billed charges · outpatientfrom % of charges	$96	$96	—	—	—	$96 – $96
21	MultiPlan multiplan percent of total billed charges · inpatientfrom % of charges	$99	$99	—	—	—	$99 – $99
22	MultiPlan multiplan percent of total billed charges · outpatientfrom % of charges	$99	$99	—	—	—	$99 – $99
23	Sanford Health Plan sanford health plan [100578] percent of total billed charges · inpatientfrom % of charges	$105	$105	—	—	—	$105 – $105
24	Sanford Health Plan sanford health plan [100578] percent of total billed charges · outpatientfrom % of charges	$105	$105	—	—	—	$105 – $105
25	Aetna aetna - fh [100925] percent of total billed charges · inpatientfrom % of charges	$111	$111	—	—	—	$111 – $111

Page 1 of 2 · 34 rates

Last updated: Feb 20, 2026

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