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Fomepizole Injection

New Hampshire rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

Facilitymedian $19 · 10th–90th $10$340%10%10th90th$19Professionalmedian $13 · 10th–90th $12$240%50%10th90th$13$10.0$20.0$50.0

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
$12.88
Typical High
$16.22
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$14.45
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$23.44
Typical High
$33.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.88
Typical High
$14.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$25.70
Typical High
$35.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$21.38
Typical High
$24.55
United
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
United
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$12.30
Typical High
$19.50