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
Enumclaw, WA
See all hospitals reporting HCPCS J0133 →Price type
Enumclaw Regional Hospital Association’s median price of $46 is 819% above the median hospital's median price ($5), higher than 78% 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: 10 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 | Aetna commercial|awh fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna commercial|all other plans fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Kaiser medicare|all plans fee schedule · outpatient | $34 | $145 | $206 | 142% | — | $11 – $502 |
| 4 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $34 | $145 | $207 | 142% | — | $11 – $502 |
| 5 | Molina medicaid|all plans fee schedule · outpatient | $34 | $146 | $208 | 142% | — | $11 – $505 |
| 6 | Optum medicare|all plans fee schedule · outpatient | $34 | $147 | $208 | 142% | — | $11 – $507 |
| 7 | Premera medicare|all plans fee schedule · outpatient | $35 | $149 | $212 | 142% | — | $12 – $517 |
| 8 | Regence medicare|all plans fee schedule · outpatient | $35 | $149 | $212 | 142% | — | $12 – $517 |
| 9 | Humana medicare|all plans fee schedule · outpatient | $36 | $155 | $221 | 142% | — | $12 – $537 |
| 10 | Molina medicare|all plans fee schedule · outpatient | $36 | $157 | $223 | 142% | — | $12 – $542 |
| 11 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $36 | $157 | $223 | 142% | — | $12 – $542 |
| 12 | Aetna medicare|all plans fee schedule · outpatient | $41 | $177 | $252 | 142% | — | $14 – $613 |
| 13 | UnitedHealthcare medicaid|all plans fee schedule · inpatient | $56 | $239 | $340 | 142% | — | $19 – $827 |
| 14 | Molina medicaid|all plans fee schedule · inpatient | $56 | $240 | $342 | 142% | — | $19 – $831 |
| 15 | Molina commercial|marketplace exchange fee schedule · outpatient | $65 | $279 | $396 | 142% | — | $22 – $964 |
| 16 | UnitedHealthcare commercial|cascade care fee schedule · inpatient | $67 | $290 | $413 | 142% | — | $22 – $1.0k |
| 17 | UnitedHealthcare commercial|navigate fee schedule · inpatient | $69 | $298 | $424 | 142% | — | $23 – $1.0k |
| 18 | UnitedHealthcare commercial|all other plans fee schedule · inpatient | $73 | $314 | $447 | 142% | — | $24 – $1.1k |
| 19 | Aetna commercial|awh fee schedule · inpatient | $75 | $323 | $458 | 142% | — | $25 – $1.1k |
| 20 | Aetna commercial|all other plans fee schedule · inpatient | $90 | $387 | $550 | 142% | — | $30 – $1.3k |
| 21 | Cigna commercial|all plans fee schedule · outpatient | $94 | $403 | $573 | 142% | — | $31 – $1.4k |
| 22 | Cigna commercial|all plans fee schedule · inpatient | $103 | $443 | $630 | 142% | — | $34 – $1.5k |
| 23 | Aetna commercial|rental fee schedule · inpatient | $135 | $581 | $825 | 142% | — | $45 – $2.0k |
| 24 | Aetna commercial|rental fee schedule · outpatient | $135 | $581 | $825 | 142% | — | $45 – $2.0k |
| 25 | MultiPlan commercial|all plans fee schedule · inpatient | $169 | $726 | $1.0k | 142% | — | $56 – $2.5k |
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.