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Tennessee rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $16 · 10th–90th $8–$320%10%20%10th90th$16Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$10.0$20.0$50.0$100.0

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
$12.59 / $16.22 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $19.95 / $22.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.61 / $13.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $13.49