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Alaska rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $0 · 10th–90th $0–$630%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$600%50%90th$0$0.0$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $63.10
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $60.26
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.37
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.22 / $0.22 / $0.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $0.18 / $223.87