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Fomepizole Injection

Nebraska rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

Facilitymedian $22 · 10th–90th $7$350%20%10th90th$22Professionalmedian $12 · 10th–90th $12$130%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
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$23.99
Typical High
$34.67
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$7.59
Typical High
$7.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$7.41
Typical High
$7.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$8.51
Typical High
$12.88
Medica
Setting
Facility
Modifier
Global
Typical Low
$6.03
Median
$18.20
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$12.30
Typical High
$15.14
Midlands
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
United
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$6.61
Typical High
$17.38
United
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$12.30
Typical High
$15.85