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Fomepizole Injection

Nebraska rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated October 2026.

How much does Fomepizole Injection cost?

$11.75per 15 mg

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $11.75 for each 15 mg of this drug. The price depends on where it is billed: about $12.30 from a physician practice, and about $7.41 from a hospital or other facility.

Work out the cost of a dose

This drug is priced per 15 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$12.30
At a hospital outpatient department
$7.41

The same drug, in the same amount, costs 40% less at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.30$8.51 to $12.30
FacilityA hospital or hospital-owned outpatient department$7.41$6.46 to $7.59

How much rates vary

Facilitymedian $7 · 10th to 90th $6 to $15Professionalmedian $12 · 10th to 90th $7 to $15
$10$20$50$100facility $7professional $12

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$12.02
Median
$15.14
Typical High
$23.99
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$6.31
Median
$7.41
Typical High
$7.59
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$7.24
Median
$7.59
Typical High
$7.59
Cigna
Setting
Professional
Modifier
None
Typical Low
$6.76
Median
$8.51
Typical High
$12.88
Medica
Setting
Facility
Modifier
None
Typical Low
$6.03
Median
$18.20
Typical High
$100.00
Medica
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$15.14
Midlands
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
United
Setting
Facility
Modifier
None
Typical Low
$6.17
Median
$6.17
Typical High
$6.17
United
Setting
Professional
Modifier
None
Typical Low
$11.75
Median
$12.30
Typical High
$15.85

Where Nebraska sits

The same service costs 3.0 times more in Arizona than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Nebraska· 48th of 51

$11.75

AZ $21.38HI $7.24

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.