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 Sol[CMH]
Astoria, OR
See all hospitals reporting HCPCS J0133 →Price type
Columbia Lutheran Charities’s median price of $46 is 809% above the median hospital's median price ($5), higher than 77% 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, 14 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 | Molina molina ma - medicare advantage facility · percent of total billed charges · bothfrom % of charges | $25 | $25 | $5 | 21% | — | $20 – $30 |
| 2 | Regence medicare facility · percent of total billed charges · bothfrom % of charges | $25 | $25 | $5 | 21% | — | $20 – $30 |
| 3 | Tricare military facility · percent of total billed charges · bothfrom % of charges | $25 | $25 | $5 | 21% | — | $20 – $30 |
| 4 | UnitedHealthcare medicare facility · percent of total billed charges · bothfrom % of charges | $25 | $25 | $5 | 21% | — | $20 – $30 |
| 5 | Aetna aetna medicare advantage - medicare advantage facility · percent of total billed charges · bothfrom % of charges | $25 | $25 | $5 | 21% | — | $20 – $31 |
| 6 | Cigna cigna medicare advantage - medicare advantage facility · percent of total billed charges · bothfrom % of charges | $26 | $26 | $5 | 21% | — | $21 – $31 |
| 7 | Molina medicaid facility · percent of total billed charges · bothfrom % of charges | $31 | $31 | $7 | 21% | — | $24 – $37 |
| 8 | Regence commercial facility · percent of total billed charges · bothfrom % of charges | $61 | $61 | $13 | 21% | — | $48 – $74 |
| 9 | First Health first health/coventry - commercial facility · percent of total billed charges · bothfrom % of charges | $62 | $62 | $13 | 21% | — | $49 – $75 |
| 10 | Premera bc premera lifewise - commercial facility · percent of total billed charges · bothfrom % of charges | $65 | $65 | $14 | 21% | — | $52 – $79 |
| 11 | UnitedHealthcare commercial facility · percent of total billed charges · bothfrom % of charges | $65 | $65 | $14 | 21% | — | $52 – $79 |
| 12 | Aetna commercial facility · percent of total billed charges · bothfrom % of charges | $66 | $66 | $14 | 21% | — | $52 – $80 |
| 13 | Cigna commercial facility · percent of total billed charges · bothfrom % of charges | $66 | $66 | $14 | 21% | — | $52 – $80 |
| 14 | MultiPlan multiplan - commercial facility · percent of total billed charges · bothfrom % of charges | $66 | $66 | $14 | 21% | — | $52 – $80 |
Last updated: Jan 5, 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.