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Fomepizole Injection

Maine rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

How much does Fomepizole Injection cost?

$12.88per 15 mg

Typical negotiated rate. In Maine, July 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 $35.48 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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
$35.48

The same drug, in the same amount, costs 175% 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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.88$12.88 to $12.88
FacilityA hospital or hospital-owned outpatient department$35.48$20.89 to $38.02

How much rates vary

Facilitymedian $35 · 10th to 90th $8 to $38Professionalmedian $13 · 10th to 90th $12 to $15
$10.0$20.0facility $35professional $13

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$38.02
Typical High
$38.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.88
Typical High
$12.88
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$7.59
Typical High
$20.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.88
Typical High
$12.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$14.45
Typical High
$37.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$15.49
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$38.02
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.88
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$12.88
Typical High
$18.20

Where Maine sits

The same service costs 2.8 times more in Colorado than in Hawaii. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maine $12.88 · 15th of 51
CO $20.42HI $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.