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Michigan rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $7 · 10th–90th $0–$430%10%10th90th$7Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$0$0.0$0.1$0.5$2.0$10.0$50.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $22.39 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.13 / $0.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.04 / $0.04
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $6.46 / $42.66
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.13 / $0.16
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.12 / $0.13