S0104
HCPCSZidovudine, oral, 100 mg
Based on the latest published hospital price files, code S0104 (Zidovudine, oral, 100 mg) appears at 6 hospitals with disclosed cash prices from $0.22 to $1.05. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Published-price availability
A blank price (“—”) means a hospital names this service but did not publish a dollar amount — it is not a free service or a $0 price.
Compare S0104 prices
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Published cash prices for code S0104 vary by about 4.8× across the 3 hospitals with disclosed prices here — from $0.22 to $1.05. Shopping around can matter.
Lowest cash price by hospital
- Mount Sinai Brooklyn$0.22
- Mount Sinai Queens$0.72
Cash price by city
Reflects your current filters.
- Brooklyn · 1 hospital$0.22–$1.05
- Long Island · 1 hospital$0.72
- New York · 1 hospital$1.05
7 prices shown.
| Service | Hospital | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|---|
| Zidovudine, oral, 100 mg Outpatient | Endeavor Health Edward Hospital | S0104 HCPCS | — | — | $3.74 – $3.74 | — | |
| Zidovudine, oral, 100 mg Outpatient | University of Chicago Medical Center | S0104 HCPCS | — | — | — | — | |
| Zidovudine, oral, 100 mg Outpatient | Hardin Memorial Hospital | S0104 HCPCS | — | — | $9.82 – $9.82 | — | |
| zidovudine 300 mg tablet 60 each Bottle Inpatient & outpatient | Mount Sinai Brooklyn | S0104 HCPCS | $1.17 | $1.05 | — | — | |
| zidovudine 100 mg capsule 100 each Bottle Inpatient & outpatient | Mount Sinai Brooklyn | S0104 HCPCS | $0.25 | $0.22 | — | — | |
| zidovudine 300 mg tablet 60 each Bottle Inpatient & outpatient | Mount Sinai Queens | S0104 HCPCS | $0.80 | $0.72 | — | — | |
| zidovudine 300 mg tablet 60 each Bottle Inpatient & outpatient | Mount Sinai Morningside | S0104 HCPCS | $1.17 | $1.05 | — | — |
How to read these prices
- Cash price
- The discounted self-pay price for paying directly, without insurance.
- List price
- The hospital’s full undiscounted charge — rarely what anyone pays.
- Negotiated rate
- A rate for a specific insurer and plan; your share depends on your benefits.
- Allowed amount
- A historical reference for what was actually allowed, where disclosed.
Hospitals that publish S0104 prices
Open a hospital to see this code in the context of its full published prices.
Code S0104: frequently asked
- What does code S0104 cost?
- Across the published hospital price files, the disclosed cash price for S0104 ranges from $0.22 to $1.05. This is public hospital price transparency data, not a guaranteed estimate of your bill.
- Will this be my final bill?
- Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.
- What is code S0104?
- S0104 is the billing code hospitals use to identify "Zidovudine, oral, 100 mg" on their published price files. We use it to line up the same service across different hospitals.
- Why do prices for this code differ between hospitals?
- Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.
- What this page is not
- It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.