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North Carolina rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $15 · 10th–90th $12–$160%20%40%10th90th$15Professionalmedian $12 · 10th–90th $12–$150%50%90th$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
$12.88 / $15.14 / $15.14
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
$17.38 / $17.38 / $20.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $13.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $19.50 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $15.14 / $18.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $10.23 / $11.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $17.38
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00