Acyclovir intravenous antiviral solution at Sanford Wheaton

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.

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Generated: October 20, 2026

Original text from hospital filings

Acyclovir Sodium IV Soln 50 MG/ML

Wheaton, MN

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How this price compares nationally

Sanford Wheaton’s median price of $29 is 501% above the median hospital's median price ($5), higher than 69% of the 2,198 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0133 at Sanford Wheaton

Negotiated rates from the hospital’s own file: 8 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	Bcbs Mn pmap percent of total billed charges · outpatientfrom % of charges	$8	$8	—	—	—	$8 – $8
2	Sanford Health Plan medicare replacement percent of total billed charges · outpatientfrom % of charges	$17	$17	—	—	—	$17 – $17
3	Ucare medicare replacement percent of total billed charges · outpatientfrom % of charges	$18	$18	—	—	—	$18 – $18
4	Aetna medicare replacement percent of total billed charges · outpatientfrom % of charges	$18	$18	—	—	—	$18 – $18
5	Bcbs Mn medicare replacement percent of total billed charges · outpatientfrom % of charges	$18	$18	—	—	—	$18 – $18
6	UnitedHealthcare medicare replacement percent of total billed charges · outpatientfrom % of charges	$18	$18	—	—	—	$18 – $18
7	Bcbs Nd commercial percent of total billed charges · outpatientfrom % of charges	$23	$23	—	—	—	$23 – $23
8	Sanford Health Plan group health/true percent of total billed charges · inpatientfrom % of charges	$26	$26	—	—	—	$26 – $26
9	Sanford Health Plan group health/true percent of total billed charges · outpatientfrom % of charges	$26	$26	—	—	—	$26 – $26
10	UnitedHealthcare commercial + top 20 percent of total billed charges · inpatientfrom % of charges	$28	$28	—	—	—	$28 – $28
11	UnitedHealthcare commercial + top 20 percent of total billed charges · outpatientfrom % of charges	$28	$28	—	—	—	$28 – $28
12	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
13	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
14	Ucare commercial percent of total billed charges · inpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
15	Ucare commercial percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
16	Medica choice percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
17	Medica choice percent of total billed charges · inpatientfrom % of charges	$30	$30	—	—	—	$30 – $30
18	MultiPlan commercial percent of total billed charges · inpatientfrom % of charges	$30	$30	—	—	—	$30 – $30
19	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$30	$30	—	—	—	$30 – $30
20	Bcbs Mn commercial/federal percent of total billed charges · outpatientfrom % of charges	$31	$31	—	—	—	$31 – $31
21	Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · inpatientfrom % of charges	$31	$31	—	—	—	$31 – $31
22	Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · outpatientfrom % of charges	$31	$31	—	—	—	$31 – $31
23	Sanford Health Plan sd exchange true percent of total billed charges · inpatientfrom % of charges	$31	$31	—	—	—	$31 – $31
24	Sanford Health Plan sd exchange true percent of total billed charges · outpatientfrom % of charges	$31	$31	—	—	—	$31 – $31
25	Medica elect percent of total billed charges · outpatientfrom % of charges	$31	$31	—	—	—	$31 – $31

Page 1 of 2 · 26 rates

Last updated: Mar 4, 2026

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