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 50MG/ML20ML INJ
Camarillo, CA
See all hospitals reporting HCPCS J0133 →Price type
Dignity Health’s median price of $9 is 91% above the median hospital's median price ($5), higher than 54% of the 2,198 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: 8 payers, 21 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna commercial|all plans fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 4 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 5 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Blue Cross Blue Shield commercial|epn fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Blue Cross Blue Shield commercial|ffs fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Anthem commercial|exchange fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Anthem commercial|non-mcs fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Anthem commercial|hmo fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Anthem commercial|mcs fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Anthem commercial|dignityhealth fee schedule · inpatient | $18 | $23 | $7 | 32% | — | $18 – $34 |
| 13 | Anthem commercial|dignityhealth fee schedule · outpatient | $18 | $23 | $7 | 32% | — | $18 – $34 |
| 14 | Cigna commercial|all other plans fee schedule · outpatient | $39 | $50 | $16 | 32% | — | $39 – $73 |
| 15 | Cigna commercial|ppo fee schedule · outpatient | $39 | $50 | $16 | 32% | — | $39 – $73 |
| 16 | Kaiser commercial|all plans fee schedule · inpatient | $42 | $54 | $17 | 32% | — | $42 – $78 |
| 17 | Kaiser commercial|all plans fee schedule · outpatient | $42 | $54 | $17 | 32% | — | $42 – $78 |
| 18 | First Health commercial|all plans fee schedule · inpatient | $46 | $58 | $18 | 32% | — | $45 – $84 |
| 19 | First Health commercial|all plans fee schedule · outpatient | $46 | $58 | $18 | 32% | — | $45 – $84 |
| 20 | MultiPlan commercial|all plans fee schedule · inpatient | $54 | $70 | $22 | 32% | — | $54 – $101 |
| 21 | MultiPlan commercial|all plans fee schedule · outpatient | $54 | $70 | $22 | 32% | — | $54 – $101 |
Last updated: Feb 28, 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.