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North Carolina rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $51 · 10th–90th $9–$1700%10%10th90th$51Professionalmedian $0 · 10th–90th $0–$00%20%40%10th$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $51.29 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.06 / $0.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $0.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.04 / $0.12
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
$0.04 / $0.12 / $0.12
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00