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Virginia rates for HCPCS J0133

Injection, acyclovir, 5 mg

Facilitymedian $47 · 10th–90th $7–$1260%10%20%10th90th$47Professionalmedian $0 · 10th–90th $0–$00%50%90th$0$0.0$0.2$2.0$20.0$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
$10.72 / $46.77 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.03
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.05 / $0.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $0.04 / $0.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.12 / $0.13 / $0.14
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.03
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.12 / $0.20
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $0.13
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $0.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.04 / $0.12 / $0.13