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Fomepizole Injection

South Dakota rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated October 2026.

How much does Fomepizole Injection cost?

$12.30per 15 mg

Typical negotiated rate. In South Dakota, October 2026.

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

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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 7 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 $12.88
FacilityA hospital or hospital-owned outpatient department$12.30$12.30 to $19.50

How much rates vary

Facilitymedian $12 · 10th to 90th $12 to $23Professionalmedian $12 · 10th to 90th $7 to $14
$10$20facility $12professional $12

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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
$12.02
Typical High
$15.14
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$15.14
Cigna
Setting
Professional
Modifier
None
Typical Low
$6.76
Median
$8.51
Typical High
$8.51
Medica
Setting
Facility
Modifier
None
Typical Low
$15.14
Median
$22.91
Typical High
$22.91
Medica
Setting
Professional
Modifier
None
Typical Low
$10.47
Median
$12.30
Typical High
$13.80
Midlands
Setting
Professional
Modifier
None
Typical Low
$11.48
Median
$11.48
Typical High
$11.48
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
United
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$13.80
Wellmark
Setting
Facility
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$12.30
Wellmark
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$12.30
Typical High
$12.30

Where South Dakota 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.

South Dakota· 36th of 51

$12.30

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.