Acyclovir intravenous antiviral solution at Carle BroMenn Medical Center

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.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
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 INTRAVENOUS SOLUTION

Normal, IL

See all hospitals reporting HCPCS J0133 →

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How this price compares nationally

Carle BroMenn Medical Center’s median price of $43 is 752% above the median hospital's median price ($5), higher than 76% of the 2,220 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0133 at Carle BroMenn Medical Center

Negotiated rates from the hospital’s own file: 8 payers, 15 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	Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient	$0	$0	—	—	—	$0 – $0
2	Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Humana medicare-medicaid (d-snp) fee schedule · inpatient	$0	$0	—	—	—	$0 – $0
4	Humana medicare-medicaid (d-snp) fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
5	Molina managed medicaid percent of total billed charges · inpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
6	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
7	Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
8	Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
9	Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges	$66	$66	—	—	—	$66 – $66
10	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$66	$66	—	—	—	$66 – $66
11	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$67	$67	—	—	—	$67 – $67
12	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$67	$67	—	—	—	$67 – $67
13	Aetna ppo percent of total billed charges · inpatientfrom % of charges	$71	$71	—	—	—	$71 – $71
14	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$71	$71	—	—	—	$71 – $71
15	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$80	$80	—	—	—	$80 – $80

Last updated: Apr 15, 2026

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