Zidovudine 100 mg oral tablet 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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ZIDOVUDINE 10 MG/ML ORAL SYRUP

Ozark, MO

See all hospitals reporting HCPCS S0104 →

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Pricing by billing methodology

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How this price compares nationally

Mercy Hospital Springfield’s median price of $15 is 587% above the median hospital's median price ($2), higher than 90% of the 839 hospitals reporting HCPCS S0104. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS S0104 at Mercy Hospital Springfield

Negotiated rates from the hospital’s own file: 11 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.

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1	Blue Cross Blue Shield hb sprg missouri care plan/healthy blue facility · percent of total billed charges · outpatientfrom % of charges	$12	$12	$11	88%	—	$2 – $23
2	Medicaid hb sprg mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$12	$12	$11	88%	—	$2 – $23
3	UnitedHealthcare hb sprg uhc mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$12	$12	$11	88%	—	$2 – $23
4	Medica hb sprg lebn medica exchange facility · percent of total billed charges · outpatientfrom % of charges	$24	$24	$21	88%	—	$3 – $46
5	Ambetter hb sprg ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges	$25	$25	$22	88%	—	$3 – $47
6	Anthem hb sprg anthem blue access facility · fee schedule · outpatient	$28	$28	$25	92%	—	$2 – $53
7	Blue Cross Blue Shield hb sprg anthem blue access facility · fee schedule · outpatient	$28	$28	$25	92%	—	$2 – $53
8	Blue Cross Blue Shield hb sprg anthem pathways exchange facility · fee schedule · outpatient	$28	$28	$25	92%	—	$2 – $53
9	Anthem hb sprg anthem alliance facility · fee schedule · outpatient	$33	$33	$31	92%	—	$3 – $64
10	Blue Cross Blue Shield hb sprg anthem alliance facility · fee schedule · outpatient	$33	$33	$31	92%	—	$3 – $64
11	First Health hb sprg aetna first health-network access facility · percent of total billed charges · outpatientfrom % of charges	$35	$35	$30	88%	—	$4 – $65
12	Humana hb sprg humana facility · percent of total billed charges · outpatientfrom % of charges	$42	$42	$37	88%	—	$5 – $79
13	Cigna hb sprg cigna hmo facility · percent of total billed charges · outpatientfrom % of charges	$43	$43	$37	88%	—	$5 – $80
14	Optum hb sprg uhc all payer facility · fee schedule · outpatient	$44	$44	$40	92%	—	$4 – $84
15	UnitedHealthcare hb sprg uhc all payer facility · fee schedule · outpatient	$44	$44	$40	92%	—	$4 – $84
16	UnitedHealthcare hb sprg uhc individual exchange facility · fee schedule · outpatient	$44	$44	$40	92%	—	$4 – $84
17	UnitedHealthcare hb sprg uhc options ppo facility · fee schedule · outpatient	$44	$44	$40	92%	—	$4 – $84
18	Blue Cross Blue Shield hb sprg anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges	$45	$45	$40	88%	—	$5 – $85
19	Blue Cross Blue Shield hb sprg anthem traditional facility · percent of total billed charges · outpatientfrom % of charges	$47	$47	$41	88%	—	$6 – $89
20	Cigna hb sprg cigna ppo facility · percent of total billed charges · outpatientfrom % of charges	$48	$48	$42	88%	—	$6 – $89
21	MultiPlan hb sprg phcs (mpi) facility · percent of total billed charges · outpatientfrom % of charges	$48	$48	$42	88%	—	$6 – $89

Last updated: Jun 4, 2026

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