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Fomepizole Injection

Washington rates for HCPCS J1451

Injection, fomepizole, 15 mg

Rates data updated July 2026.

Facilitymedian $10 · 10th–90th $6$210%10%20%10th90th$10Professionalmedian $13 · 10th–90th $12$140%50%10th90th$13$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
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$30.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$14.45
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$9.77
Typical High
$13.18
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$24.55
Typical High
$25.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$75.86
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$10.72
Typical High
$16.98
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$6.46
Median
$7.94
Typical High
$13.18
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
United
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$6.61
Typical High
$6.61
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$12.30