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Michigan rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $22 · 10th–90th $12–$380%20%10th90th$22Professionalmedian $12 · 10th–90th $10–$160%50%10th90th$12$10.0$20.0$50.0$100.0

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
$12.02 / $33.88 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $21.38 / $43.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $7.59 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $12.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $21.38 / $42.66
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $16.22 / $21.88
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $10.96
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 / $13.18