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Iowa rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $12 · 10th–90th $12–$150%50%90th$12Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$1.0$2.0$5.0$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
$12.02 / $15.14 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $8.51 / $8.51
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $20.89 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $8.13 / $18.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $12.30 / $16.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $18.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $13.18
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30