Acyclovir intravenous antiviral solution at Piedmont Walton

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

Monroe, GA

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How this price compares nationally

Piedmont Walton’s median price of $55 is 1055% above the median hospital's median price ($5), higher than 81% of the 2,187 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0133 at Piedmont Walton

Negotiated rates from the hospital’s own file: 9 payers, 12 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	Caresource caresource medicaid fee schedule · both	$14	$14	—	—	—	$14 – $14
2	UnitedHealthcare united healthcare fee schedule · both	$23	$23	—	—	—	$23 – $23
3	UnitedHealthcare united healthcare exchange fee schedule · both	$23	$23	—	—	—	$23 – $23
4	Cigna cigna fee schedule · both	$31	$31	—	—	—	$31 – $31
5	Cigna cigna connect fee schedule · both	$31	$31	—	—	—	$31 – $31
6	Blue Cross Blue Shield blue cross hmo percent of total billed charges · bothfrom % of charges	$54	$54	—	—	—	$54 – $54
7	Blue Cross Blue Shield blue cross ppo percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
8	First Health first health percent of total billed charges · bothfrom % of charges	$85	$85	—	—	—	$85 – $85
9	MultiPlan multiplan percent of total billed charges · bothfrom % of charges	$97	$97	—	—	—	$97 – $97
10	Phcs phcs percent of total billed charges · bothfrom % of charges	$97	$97	—	—	—	$97 – $97
11	Kaiser kaiser percent of total billed charges · bothfrom % of charges	$103	$103	—	—	—	$103 – $103
12	Beechstreet beechstreet percent of total billed charges · bothfrom % of charges	$109	$109	—	—	—	$109 – $109

Last updated: Jul 1, 2026

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