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New Mexico rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $55 · 10th–90th $0–$7410%20%10th90th$55Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$0$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$54.95 / $54.95 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.04 / $0.47
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.12 / $0.12