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Massachusetts rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $16 · 10th–90th $12–$300%20%10th90th$16Professionalmedian $13 · 10th–90th $12–$210%20%40%10th90th$13$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $19.95 / $26.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $21.88 / $39.81
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $12.30 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $27.54 / $56.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $12.88 / $12.88
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $12.59 / $7,079.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $21.38
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $21.88 / $39.81
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $12.30 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.61 / $13.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.88 / $13.49