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 SODIUM 50 MG/ML INTRAVENOUS SOLUTION
Macon, GA
See all hospitals reporting HCPCS J0133 →Price type
Central Georgia Rehabilitation LLC’s median price of $38 is 648% 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: 9 payers, 26 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 | Anthem hmo/ppo fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Cigna commercial fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Aetna hmo fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Aetna pos fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Aetna ppo fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Humana hmo/pos fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Humana ppo fee schedule · both | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Kaiser commercial fee schedule · both | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Ambetter managed medicaid percent of total billed charges · outpatientfrom % of charges | $19 | $25 | $16 | 63% | — | $14 – $62 |
| 10 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $26 | $34 | $21 | 63% | — | $18 – $83 |
| 11 | Anthem hmo/ppo percent of total billed charges · inpatientfrom % of charges | $28 | $37 | $23 | 63% | — | $20 – $90 |
| 12 | Ambetter managed medicaid percent of total billed charges · inpatientfrom % of charges | $33 | $43 | $27 | 63% | — | $23 – $105 |
| 13 | Humana hmo/pos percent of total billed charges · outpatientfrom % of charges | $38 | $50 | $31 | 63% | — | $27 – $121 |
| 14 | Aetna hmo percent of total billed charges · outpatientfrom % of charges | $38 | $50 | $32 | 63% | — | $27 – $122 |
| 15 | Aetna pos percent of total billed charges · outpatientfrom % of charges | $42 | $55 | $35 | 63% | — | $30 – $134 |
| 16 | Kaiser commercial percent of total billed charges · inpatientfrom % of charges | $42 | $55 | $35 | 63% | — | $30 – $134 |
| 17 | Kaiser commercial percent of total billed charges · outpatientfrom % of charges | $42 | $55 | $35 | 63% | — | $30 – $134 |
| 18 | MultiPlan pho agreement primary network percent of total billed charges · inpatientfrom % of charges | $42 | $55 | $35 | 63% | — | $30 – $134 |
| 19 | MultiPlan pho agreement primary network percent of total billed charges · outpatientfrom % of charges | $42 | $55 | $35 | 63% | — | $30 – $134 |
| 20 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $43 | $56 | $35 | 63% | — | $30 – $136 |
| 21 | Humana ppo percent of total billed charges · outpatientfrom % of charges | $45 | $58 | $37 | 63% | — | $31 – $141 |
| 22 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $45 | $58 | $37 | 63% | — | $31 – $142 |
| 23 | MultiPlan pho agreement complimentary network percent of total billed charges · inpatientfrom % of charges | $52 | $68 | $43 | 63% | — | $36 – $165 |
| 24 | MultiPlan pho agreement complimentary network percent of total billed charges · outpatientfrom % of charges | $52 | $68 | $43 | 63% | — | $36 – $165 |
| 25 | Beechstreet commercial percent of total billed charges · inpatientfrom % of charges | $60 | $79 | $50 | 63% | — | $42 – $192 |
Last updated: Nov 19, 2025
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.