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Maryland rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $6,310 · 10th–90th $13–$6,3100%50%10th$6,310Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$10.0$50.0$200.0$1.0K$5.0K

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
$12.88 / $6,309.57 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $10.72 / $15.85
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $15.49
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $7.59