Acyclovir intravenous antiviral solution at Mercy Hospital Springfield

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

ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION

Ozark, MO

See all hospitals reporting HCPCS J0133 →

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Pricing by billing methodology

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How this price compares nationally

Mercy Hospital Springfield’s median price of $26 is 440% above the median hospital's median price ($5), higher than 67% of the 2,202 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0133 at Mercy Hospital Springfield

Negotiated rates from the hospital’s own file: 12 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	Medicaid hb sprg/jopl ark medicaid facility · fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
2	Anthem hb sprg anthem blue access facility · fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
3	Blue Cross Blue Shield hb sprg anthem blue access facility · fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
4	Blue Cross Blue Shield hb sprg anthem pathways exchange facility · fee schedule · outpatient	$4	$4	—	—	—	$4 – $4
5	Cigna hb sprg cigna hmo facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
6	Cigna hb sprg cigna ppo facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
7	Aetna hb sprg ok medicaid facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
8	Anthem hb sprg anthem alliance facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
9	Blue Cross Blue Shield hb sprg anthem alliance facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
10	Humana hb sprg ok medicaid facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
11	Medicaid hb sprg ok medicaid facility · fee schedule · outpatient	$5	$5	—	—	—	$5 – $5
12	Blue Cross Blue Shield hb sprg missouri care plan/healthy blue facility · percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
13	Medicaid hb sprg mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
14	UnitedHealthcare hb sprg uhc mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$10	$10	—	—	—	$10 – $10
15	Blue Cross Blue Shield hb sprg kancare healthy blue medicaid facility · fee schedule · outpatient	$12	$12	—	—	—	$12 – $12
16	Optum hb sprg uhc all payer facility · fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
17	UnitedHealthcare hb sprg uhc all payer facility · fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
18	UnitedHealthcare hb sprg uhc individual exchange facility · fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
19	UnitedHealthcare hb sprg uhc options ppo facility · fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
20	Medica hb sprg lebn medica exchange facility · percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
21	Ambetter hb sprg ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
22	First Health hb sprg aetna first health-network access facility · percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
23	Humana hb sprg humana facility · percent of total billed charges · outpatientfrom % of charges	$36	$36	—	—	—	$36 – $36
24	Blue Cross Blue Shield hb sprg anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges	$38	$38	—	—	—	$38 – $38
25	Blue Cross Blue Shield hb sprg anthem traditional facility · percent of total billed charges · outpatientfrom % of charges	$40	$40	—	—	—	$40 – $40

Page 1 of 2 · 26 rates

Last updated: Jun 4, 2026

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