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Acyclovir Injection

Montana rates for HCPCS J0133

Injection, acyclovir, 5 mg

Rates data updated July 2026.

How much does Acyclovir Injection cost?

$0.06per 5 mg

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $0.06 for each 5 mg of this drug. The price depends on where it is billed: about $0.06 from a physician practice, and about $0.08 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
$0.06
At a hospital outpatient department
$0.08

The same drug, in the same amount, costs 32% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 6 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$0.06$0.02 to $0.12
FacilityA hospital or hospital-owned outpatient department$0.08$0.06 to $0.24

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $0
$0.1$1$10$100$1K$10K$100Kfacility $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
$0.28
Median
$1.00
Typical High
$1.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.17
BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.13
Median
$0.31
Typical High
$89,125.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.04
Median
$0.04
Typical High
$0.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.04
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$0.05
Median
$0.06
Typical High
$0.16
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$0.05
Median
$0.06
Typical High
$0.16
Providence
Setting
Facility
Modifier
Global
Typical Low
$0.04
Median
$0.04
Typical High
$0.20
Providence
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$79.43
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$0.12
Median
$0.12
Typical High
$0.12

Where Montana 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.

Montana· 11th of 51

$0.06

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.