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Missouri rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $14 · 10th–90th $7–$320%10%10th90th$14Professionalmedian $12 · 10th–90th $11–$200%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 / $15.14 / $48.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $20.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $11.48 / $32.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $11.48 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $21.38 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $18.20 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $12.30 / $14.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $7.59 / $19.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $12.30 / $15.14