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Fomepizole Injection

North Carolina rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

Facilitymedian $15 · 10th–90th $11$160%20%40%10th90th$15Professionalmedian $15 · 10th–90th $12$150%50%10th90th$15$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
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$15.14
Typical High
$15.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$15.14
Typical High
$15.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$13.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$19.50
Typical High
$30.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$15.14
Medcost
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$15.14
Typical High
$18.20
United
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$10.72
Typical High
$12.02
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$16.22
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00