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Fomepizole Injection

Illinois rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

Facilitymedian $19 · 10th–90th $11$370%10%20%10th90th$19Professionalmedian $12 · 10th–90th $12$260%50%90th$12$10.0$20.0$50.0$100.0$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
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$19.50
Typical High
$28.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$26.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$8.91
Median
$30.20
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$23.99
Typical High
$30.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$125.89
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$9.55
United
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$6.61
Typical High
$10.72
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$13.18