Fomepizole injection, per 15 mg at AMH Cath Labs LLC

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLN [11594]

Arlington, TX

See all hospitals reporting HCPCS J1451 →

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Pricing by billing methodology

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How this price compares nationally

AMH Cath Labs LLC’s median price of $1.3k is 4056% above the median hospital's median price ($31), higher than 74% of the 2,022 hospitals reporting HCPCS J1451. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J1451 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 9 payers, 33 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield medicare advantage case rate · outpatient	$6	$6	—	—	—	$6 – $6
2	Humana medicare advantage case rate · outpatient	$7	$7	—	—	—	$7 – $7
3	Humana medicare advantage ppo case rate · outpatient	$7	$7	—	—	—	$7 – $7
4	Molina medicare advantage case rate · outpatient	$7	$7	—	—	—	$7 – $7
5	WellCare medicare advantage hmo case rate · outpatient	$7	$7	—	—	—	$7 – $7
6	WellCare medicare advantage mmp case rate · outpatient	$7	$7	—	—	—	$7 – $7
7	UnitedHealthcare medicare advantage ppo case rate · outpatient	$7	$7	—	—	—	$7 – $7
8	UnitedHealthcare medicare advantage hmo case rate · outpatient	$7	$7	—	—	—	$7 – $7
9	Blue Cross Blue Shield hmo fee schedule · outpatient	$21	$21	—	—	—	$21 – $21
10	Blue Cross Blue Shield exchange fee schedule · outpatient	$22	$22	—	—	—	$22 – $22
11	Blue Cross Blue Shield ppo fee schedule · outpatient	$24	$24	—	—	—	$24 – $24
12	UnitedHealthcare all payer fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
13	UnitedHealthcare ppo fee schedule · outpatient	$28	$28	—	—	—	$28 – $28
14	Blue Cross Blue Shield traditional fee schedule · outpatient	$97	$97	—	—	—	$97 – $97
15	Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges	$302	$302	—	—	—	$302 – $302
16	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$302	$302	—	—	—	$302 – $302
17	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$317	$317	—	—	—	$317 – $317
18	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$326	$326	—	—	—	$326 – $326
19	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$332	$332	—	—	—	$332 – $332
20	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
21	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
22	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k
23	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$1.9k	$1.9k	—	—	—	$1.9k – $1.9k
24	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$1.9k	$1.9k	—	—	—	$1.9k – $1.9k
25	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$2.4k	$2.4k	—	—	—	$2.4k – $2.4k

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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