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Oregon rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $13 · 10th–90th $11–$300%20%10th90th$13Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$5.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $12.88 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $14.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $16.98 / $17.78
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $13.18 / $17.78
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $13.18 / $16.22
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $12.88 / $20.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $17.78 / $37.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $12.88 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $12.59 / $23.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $13.49 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30