Acyclovir intravenous antiviral solution at Glendale Adventist Medical Center

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.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

INJECTION, ACYCLOVIR, 5 MG

Glendale, CA

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How this price compares nationally

Glendale Adventist Medical Center’s median price of $178 is 3427% above the median hospital's median price ($5), higher than 97% of the 2,220 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0133 at Glendale Adventist Medical Center

Negotiated rates from the hospital’s own file: 10 payers, 19 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	Blue Cross Blue Shield blue cross exchange fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
2	Blue Cross Blue Shield blue cross non-mcs fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Blue Cross Blue Shield blue cross mcs - all other plans fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
4	Blue Cross Blue Shield blue shield medi-cal percent of total billed charges · outpatientfrom % of charges	$74	$74	—	—	—	$74 – $74
5	Blue Cross Blue Shield blue shield epn - all other plans percent of total billed charges · outpatientfrom % of charges	$119	$119	—	—	—	$119 – $119
6	UnitedHealthcare uhc jll csp percent of total billed charges · outpatientfrom % of charges	$124	$124	—	—	—	$124 – $124
7	UnitedHealthcare uhc all payer - all other plans percent of total billed charges · outpatientfrom % of charges	$131	$131	—	—	—	$131 – $131
8	UnitedHealthcare uhc hmo percent of total billed charges · outpatientfrom % of charges	$131	$131	—	—	—	$131 – $131
9	Blue Cross Blue Shield blue shield non epn percent of total billed charges · outpatientfrom % of charges	$137	$137	—	—	—	$137 – $137
10	Cigna cigna all other - all other plans percent of total billed charges · outpatientfrom % of charges	$147	$147	—	—	—	$147 – $147
11	Cigna cigna hmo percent of total billed charges · outpatientfrom % of charges	$147	$147	—	—	—	$147 – $147
12	Optum optum health - all other plans percent of total billed charges · outpatientfrom % of charges	$153	$153	—	—	—	$153 – $153
13	Optum optum health mcr adv percent of total billed charges · outpatientfrom % of charges	$153	$153	—	—	—	$153 – $153
14	First Health first health- all plans percent of total billed charges · outpatientfrom % of charges	$187	$187	—	—	—	$187 – $187
15	Phcs phcs- all plans percent of total billed charges · outpatientfrom % of charges	$210	$210	—	—	—	$210 – $210
16	Kaiser kaiser - all plans percent of total billed charges · outpatientfrom % of charges	$275	$275	—	—	—	$275 – $275
17	Medicaid medi-cal fee schedule · outpatient	$323	$323	—	—	—	$323 – $323
18	Molina molina mcal fee schedule · outpatient	$323	$323	—	—	—	$323 – $323
19	Aetna aetna - all plans fee schedule · outpatient	$752	$752	—	—	—	$752 – $752

Last updated: Jul 30, 2026

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