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Georgia rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $13 · 10th–90th $10–$620%20%10th90th$13Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$10.0$20.0$50.0

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
$12.02 / $12.59 / $14.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $23.99 / $67.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $14.79 / $14.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $14.45 / $23.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.45 / $14.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $12.02 / $16.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $16.60