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Louisiana rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $14 · 10th–90th $7–$160%50%10th90th$14Professionalmedian $14 · 10th–90th $12–$150%20%40%10th90th$14$10.0$20.0

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
$15.14 / $15.14 / $21.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $14.13 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $14.45
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $14.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $15.49 / $25.70
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
$6.17 / $6.61 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $15.14