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Fomepizole Injection

Indiana rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

Facilitymedian $19 · 10th–90th $9$300%20%10th90th$19Professionalmedian $12 · 10th–90th $7$120%50%10th90th$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
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$29.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$18.62
Typical High
$25.12
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$13.49
CareSource
Setting
Facility
Modifier
Global
Typical Low
$6.03
Median
$10.72
Typical High
$12.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$35.48
Typical High
$35.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
United
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$11.48
Typical High
$12.88
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$25.12