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Virginia rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $14 · 10th–90th $7–$280%10%10th90th$14Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$0.2$0.5$1.0$2.0$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 / $23.99 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $13.49 / $22.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $25.12 / $32.36
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 / $10.00 / $15.85
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $16.60
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $19.50
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $13.49 / $18.20
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $13.49 / $18.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $7.59 / $13.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.30 / $15.49