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
Acetam 650mg/65ml Premix
Great Barrington, MA
See all hospitals reporting HCPCS J0131 →Price type
Fairview Hospital’s median price of $33 is 1483% above the median hospital's median price ($2), higher than 70% of the 1,916 hospitals reporting HCPCS J0131. 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, 36 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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Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Medicare mcr traditional medicare professional · fee schedule · outpatient | $0.04 | $0.04 | $0.04 – $0.04 |
| 2 | Medicare mcrmanaged medicare hmo professional · fee schedule · outpatient | $0.04 | $0.04 | $0.04 – $0.04 |
| 3 | UnitedHealthcare mcrmanaged united vaccn professional · fee schedule · outpatient | $0.04 | $0.04 | $0.04 – $0.04 |
| 4 | Blue Cross Blue Shield mcrmanaged blue cross vt medicare hmo professional · fee schedule · outpatient | $0.05 | $0.05 | $0.05 – $0.05 |
| 5 | Aetna comm aetna professional · fee schedule · outpatient | $0.06 | $0.06 | $0.06 – $0.06 |
| 6 | Blue Cross Blue Shield mcrmanaged blue cross vt medicare hmo facility · fee schedule · outpatient | $17.74 | $17.74 | $13.90 – $21.57 |
| 7 | Medicare mcr traditional medicare facility · fee schedule · outpatient | $17.74 | $17.74 | $13.90 – $21.57 |
| 8 | Medicare mcrmanaged medicare hmo facility · fee schedule · outpatient | $17.74 | $17.74 | $13.90 – $21.57 |
| 9 | UnitedHealthcare mcrmanaged united vaccn facility · fee schedule · outpatient | $18.03 | $18.03 | $14.13 – $21.92 |
| 10 | Blue Cross Blue Shield comm blue cross ma hmo facility · percent of total billed charges · outpatientfrom % of charges | $28.09 | $28.09 | $22.02 – $34.15 |
| 11 | Blue Cross Blue Shield comm blue cross ma indem facility · percent of total billed charges · outpatientfrom % of charges | $31.35 | $31.35 | $24.57 – $38.12 |
| 12 | Blue Cross Blue Shield comm blue cross ma ppo facility · percent of total billed charges · outpatientfrom % of charges | $31.51 | $31.51 | $24.70 – $38.32 |
| 13 | UnitedHealthcare comm united bh facility · percent of total billed charges · outpatientfrom % of charges | $31.67 | $31.67 | $24.82 – $38.51 |
| 14 | UnitedHealthcare comm united bh professional · fee schedule · outpatient | $31.67 | $31.67 | $24.82 – $38.51 |
| 15 | Blue Cross Blue Shield comm blue cross vt ppo facility · percent of total billed charges · inpatientfrom % of charges | $35.08 | $35.08 | $27.50 – $42.65 |
| 16 | Blue Cross Blue Shield comm blue cross vt ppo facility · percent of total billed charges · outpatientfrom % of charges | $35.08 | $35.08 | $27.50 – $42.65 |
| 17 | Aetna comm aetna facility · percent of total billed charges · inpatientfrom % of charges | $36.05 | $36.05 | $28.26 – $43.84 |
| 18 | Aetna comm aetna facility · percent of total billed charges · outpatientfrom % of charges | $36.05 | $36.05 | $28.26 – $43.84 |
| 19 | Blue Cross Blue Shield comm blue cross vt ppo professional · fee schedule · outpatient | $41.41 | $41.41 | $32.46 – $50.35 |
| 20 | UnitedHealthcare comm unitedhealthcare facility · percent of total billed charges · inpatientfrom % of charges | $41.90 | $41.90 | $32.84 – $50.95 |
| 21 | UnitedHealthcare comm unitedhealthcare facility · percent of total billed charges · outpatientfrom % of charges | $41.90 | $41.90 | $32.84 – $50.95 |
| 22 | UnitedHealthcare comm unitedhealthcare professional · fee schedule · outpatient | $41.90 | $41.90 | $32.84 – $50.95 |
| 23 | Cigna comm cigna carelink facility · percent of total billed charges · outpatientfrom % of charges | $43.85 | $43.85 | $34.37 – $53.32 |
| 24 | Cigna comm cigna hmo pos facility · percent of total billed charges · outpatientfrom % of charges | $43.85 | $43.85 | $34.37 – $53.32 |
| 25 | Cigna comm cigna carelink professional · fee schedule · outpatient | $43.85 | $43.85 | $34.37 – $53.32 |
Last updated: Oct 7, 2026
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