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Indiana rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $19 · 10th–90th $9–$300%20%10th90th$19Professionalmedian $12 · 10th–90th $8–$150%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $12.88 / $54.95
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
$8.13 / $18.62 / $27.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $13.49
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $10.72 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $12.30 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $25.12