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Fomepizole Injection

Massachusetts rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated October 2026.

How much does Fomepizole Injection cost?

$12.88per 15 mg

Typical negotiated rate. In Massachusetts, October 2026.

Insurers have agreed to pay about $12.88 for each 15 mg of this drug. The price depends on where it is billed: about $12.88 from a physician practice, and about $16.22 from a hospital or other facility.

Work out the cost of a dose

This drug is priced per 15 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$12.88
At a hospital outpatient department
$16.22

The same drug, in the same amount, costs 26% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.88$12.30 to $13.49
FacilityA hospital or hospital-owned outpatient department$16.22$12.88 to $25.70

How much rates vary

Facilitymedian $16 · 10th to 90th $7 to $37Professionalmedian $13 · 10th to 90th $12 to $19
$10$20$50facility $16professional $13

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$21.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$7.08
Median
$20.89
Typical High
$38.90
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$12.30
Typical High
$18.62
BCBS Massachusetts
Setting
Facility
Modifier
None
Typical Low
$14.45
Median
$16.22
Typical High
$29.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$16.60
Median
$26.92
Typical High
$56.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$16.22
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$7.76
Median
$9.12
Typical High
$83.18
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.88
Typical High
$20.89
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$7.08
Median
$20.89
Typical High
$38.90
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$12.30
Typical High
$18.62
United
Setting
Facility
Modifier
None
Typical Low
$6.17
Median
$6.17
Typical High
$6.17
United
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$20.89
Well Sense
Setting
Facility
Modifier
None
Typical Low
$12.88
Median
$17.78
Typical High
$26.30
Well Sense
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$15.49

Where Massachusetts sits

The same service costs 3.0 times more in Arizona than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 14th of 51

$12.88

AZ $21.38HI $7.24

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.