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Nebraska rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $12 · 10th–90th $7–$350%10%20%10th90th$12Professionalmedian $12 · 10th–90th $12–$200%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
$12.02 / $23.99 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $20.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $7.59 / $7.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $7.41 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $8.51 / $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
$11.22 / $12.30 / $15.14
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $8.51 / $8.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $6.61 / $16.22
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $12.30 / $15.85