Fomepizole injection, per 15 mg at Dignity Health

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

FOMEPIZO 1GM/ML 1.5MLJWTB

Carmichael, CA

See all hospitals reporting HCPCS J1451 →

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Pricing by billing methodology

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How this price compares nationally

Dignity Health’s median price of $15 is 51% below the median hospital's median price ($31), higher than 38% of the 2,012 hospitals reporting HCPCS J1451. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J1451 at Dignity Health

Negotiated rates from the hospital’s own file: 10 payers, 37 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	Anthem commercial\|connection epo fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
2	Anthem commercial\|all other plans fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
3	Anthem commercial\|mcs fee schedule · outpatient	$3	$3	—	—	—	$3 – $3
4	Anthem medicare\|all other plans fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
5	Aetna medicare\|all plans fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
6	Blue Cross Blue Shield medicare\|hmo case rate · outpatient	$8	$8	—	—	—	$8 – $8
7	Blue Cross Blue Shield medicare\|ppo fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
8	Humana commercial\|all plans fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
9	Humana medicare\|all plans fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
10	Kaiser medicare\|all plans case rate · outpatient	$8	$8	—	—	—	$8 – $8
11	Molina medicare\|all plans fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
12	UnitedHealthcare medicare\|all plans fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
13	Anthem medicare\|imperial fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
14	UnitedHealthcare commercial\|non-options ppo fee schedule · outpatient	$9	$9	—	—	—	$9 – $9
15	UnitedHealthcare commercial\|all other plans fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
16	UnitedHealthcare commercial\|hmo fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
17	UnitedHealthcare commercial\|options ppo fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
18	Blue Cross Blue Shield commercial\|aco trio fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
19	Blue Cross Blue Shield commercial\|aco trio calpers fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
20	Blue Cross Blue Shield commercial\|calpers fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
21	Blue Cross Blue Shield commercial\|exchange fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
22	Blue Cross Blue Shield commercial\|hmo fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
23	Blue Cross Blue Shield commercial\|ppo fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
24	Blue Cross Blue Shield commercial\|ppo tandem fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
25	Molina medicaid\|all plans fee schedule · outpatient	$28	$28	—	—	—	$28 – $28

Page 1 of 2 · 37 rates

Last updated: Feb 28, 2026

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