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Colorado rates for HCPCS J0133

Injection, acyclovir, 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $23.99 / $48.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.24 / $0.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.11 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $1.00 / $1.00
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12