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Oklahoma rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $1 · 10th–90th $1–$430%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$00%20%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
$40.74 / $42.66 / $123.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.52 / $0.81 / $1.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $0.06 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $0.04 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.07 / $0.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.12 / $0.12