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Utah rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $12 · 10th–90th $11–$170%50%10th90th$12Professionalmedian $12 · 10th–90th $7–$150%50%10th90th$12$5.0$10.0$20.0

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 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $12.59 / $19.50
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.80 / $7.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30