Acyclovir intravenous antiviral solution at Shannon River Crest Hospital

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 per 5 mg

San Angelo, TX

See all hospitals reporting HCPCS J0133 →

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Pricing by billing methodology

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How this price compares nationally

Shannon River Crest Hospital’s median price of $68 is 1306% above the median hospital's median price ($5), higher than 85% 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 Shannon River Crest Hospital

Negotiated rates from the hospital’s own file: 6 payers, 15 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 Tx hmo facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
2	Bcbs Tx bav facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Bcbs Tx ppo facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
4	Aetna ppo facility · percent of total billed charges · inpatientfrom % of charges	$87	$87	$29	34%	—	$58 – $116
5	Aetna ppo facility · percent of total billed charges · outpatientfrom % of charges	$87	$87	$29	34%	—	$58 – $116
6	Cigna ppo facility · percent of total billed charges · outpatientfrom % of charges	$95	$95	$32	34%	—	$63 – $127
7	Bcbs Tx bav facility · percent of total billed charges · inpatientfrom % of charges	$99	$99	$33	34%	—	$66 – $132
8	Bcbs Tx hmo facility · percent of total billed charges · inpatientfrom % of charges	$99	$99	$33	34%	—	$66 – $132
9	Bcbs Tx ppo facility · percent of total billed charges · inpatientfrom % of charges	$99	$99	$33	34%	—	$66 – $132
10	First Health ppo facility · percent of total billed charges · inpatientfrom % of charges	$99	$99	$33	34%	—	$66 – $132
11	First Health ppo facility · percent of total billed charges · outpatientfrom % of charges	$99	$99	$33	34%	—	$66 – $132
12	UnitedHealthcare ppo facility · percent of total billed charges · inpatientfrom % of charges	$103	$103	$35	34%	—	$68 – $138
13	UnitedHealthcare ppo facility · percent of total billed charges · outpatientfrom % of charges	$103	$103	$35	34%	—	$68 – $138
14	Humana ppo facility · percent of total billed charges · inpatientfrom % of charges	$106	$106	$36	34%	—	$70 – $141
15	Humana ppo facility · percent of total billed charges · outpatientfrom % of charges	$106	$106	$36	34%	—	$70 – $141

Last updated: Dec 8, 2025

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