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 500 MG/10 ML Vial
Mitchell, SD
See all hospitals reporting HCPCS J0133 →Price type
Avera Queen of Peace’s median price of $40 is 695% above the median hospital's median price ($5), higher than 75% 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: 4 payers, 9 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 | Wellmark ppo fee schedule · outpatient | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 2 | Wellmark hmo outpatient | $8 | $8 | — | — | 1–10 | $8 – $8 |
| 3 | Medica com fee schedule · outpatient | $31 | $31 | — | — | — | $31 – $31 |
| 4 | Medica ind fee schedule · outpatient | $31 | $31 | — | — | — | $31 – $31 |
| 5 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $49 | $49 | — | — | — | $49 – $49 |
| 6 | Medica ind percent of total billed charges · inpatientfrom % of charges | $57 | $57 | — | — | — | $57 – $57 |
| 7 | Medica com percent of total billed charges · inpatientfrom % of charges | $67 | $67 | — | — | — | $67 – $67 |
| 8 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 9 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | 1–10 | $78 – $78 |
Last updated: Apr 1, 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.