Fomepizole- 15 mg

Reported by 86 hospitals in the network under the fee schedule methodology.

Filter by billing methodology

Reflects negotiated fee schedule rates with commercial payers.

National pricing summary

Low

Average

$11

Median

High

$24

#	Hospital	Location
1	Virginia Mason Medical Center	Seattle, WA	$6	$9	$6	—	$4	$22
2	IHC Health Services Inc., DBA Intermountain Health Intermountain Medical Center	Murray, UT	$6	$9	$3	—	$6	$14
3	IHC Health Services Inc., DBA Intermountain Health Utah Valley Hospital	Provo, UT	$7	$9	$3	—	$5	$14
4	IHC Health Services Inc., DBA Intermountain Health McKay-Dee Hospital	Ogden, UT	$7	$8	$3	—	$5	$14
5	IHC Health Services Inc., DBA Intermountain Health St George Regional Hospital	St. George, UT	$7	$7	$2	—	$6	$14
6	IHC Health Services Inc., DBA Intermountain Health LDS Hospital	Salt Lake City, UT	$7	$9	$3	—	$6	$14
7	Scl Health - Montana, Dba Intermountain Health St. Vincent Healthcare	Billings, MT	$15	$15	$5	—	$6	$24
8	Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph Hospital	DENVER, CO	$13	$13	$3	—	$6	$16
9	IHC Health Services Inc., DBA Intermountain Health Logan Regional Hospital	Logan, UT	$7	$7	$2	—	$5	$14
10	St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional Hospital	JUNCTION, CO	$24	$17	$11	—	$6	$42

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