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New Mexico rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $30 · 10th–90th $10–$590%20%10th90th$30Professionalmedian $12 · 10th–90th $12–$140%50%90th$12$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$28.84 / $28.84 / $28.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $16.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $37.15 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $7.08
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.41 / $15.14 / $25.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.61 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30