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Kansas rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $13 · 10th–90th $7–$150%20%40%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 / $12.02 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.79 / $15.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $14.45 / $21.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $12.30 / $18.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $6.61 / $7.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $15.85