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.
Original text from hospital filings
Acyclovir 500 MG/10 ML Vial
Wagner, SD
See all hospitals reporting HCPCS J0133 →Price type
Wagner Community Memorial’s median price of $28 is 495% above the median hospital's median price ($5), higher than 69% of the 2,187 hospitals reporting HCPCS J0133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 10 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica ind percent of total billed charges · inpatientfrom % of charges | $20 | $20 | — | — | — | $20 – $20 |
| 2 | Medica com percent of total billed charges · inpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 3 | Wellmark ppo percent of total billed charges · inpatientfrom % of charges | $26 | $26 | — | — | — | $26 – $26 |
| 4 | Wellmark ppo percent of total billed charges · outpatientfrom % of charges | $26 | $26 | — | — | — | $26 – $26 |
| 5 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $27 | $27 | — | — | — | $27 – $27 |
| 6 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $27 | $27 | — | — | 1–10 | $27 – $27 |
| 7 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 8 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 9 | Medica com fee schedule · outpatient | $31 | $31 | — | — | — | $31 – $31 |
| 10 | Medica ind fee schedule · outpatient | $31 | $31 | — | — | — | $31 – $31 |
Last updated: Apr 1, 2026
See Acyclovir intravenous antiviral solution pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.