go back

Washington rates for HCPCS J1451

Injection, fomepizole, 15 mg

Facilitymedian $10 · 10th–90th $6–$300%10%20%10th90th$10Professionalmedian $12 · 10th–90th $12–$150%50%90th$12$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $9.77 / $20.42
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $10.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $24.55 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $75.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $10.72 / $16.98
Premera BCBS
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
$6.61 / $9.77 / $20.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $10.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30