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Mississippi rates for HCPCS J1451

Injection, fomepizole, 15 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.43 / $18.19 / $18.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.43 / $12.89 / $18.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.62 / $10.62 / $11.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.37 / $12.89 / $12.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.89 / $12.89 / $12.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.93 / $12.43 / $15.91