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Arizona rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $28 · 10th–90th $11–$720%10%10th90th$28Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$10.0$20.0$50.0$100.0

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
$16.22 / $26.30 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $46.77 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $23.99 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $21.38 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $16.60 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.61 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30