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Acyclovir Injection

Missouri rates for HCPCS J0133

Injection, acyclovir, 5 mg

Rates data updated July 2026.

How much does Acyclovir Injection cost?

$0.02per 5 mg

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $0.02 for each 5 mg of this drug. The price depends on where it is billed: about $0.02 from a physician practice, and about $0.15 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per 5 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$0.02
At a hospital outpatient department
$0.15

The same drug, in the same amount, costs 659% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.02$0.02 to $0.03
FacilityA hospital or hospital-owned outpatient department$0.15$0.02 to $0.24

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $0
$0.02$0.05$0.1$0.2$0.5$1$2facility $0professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$0.15
Typical High
$0.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$0.05
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$0.04
Typical High
$0.06
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.03
Median
$0.17
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.03
Median
$0.03
Typical High
$0.04
United
Setting
Facility
Modifier
Global
Typical Low
$0.05
Median
$0.16
Typical High
$0.17
United
Setting
Professional
Modifier
Global
Typical Low
$0.10
Median
$0.12
Typical High
$0.13

Where Missouri sits

The same service costs 26.3 times more in Oklahoma than in Missouri. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Missouri· 51st of 51

$0.02

OK $0.52MO $0.02

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.