Fomepizole injection, per 15 mg at UPMC Hanover

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 SOLUTION

Hanover, PA

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How this price compares nationally

UPMC Hanover’s median price of $394 is 1177% above the median hospital's median price ($31), higher than 61% 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 UPMC Hanover

Negotiated rates from the hospital’s own file: 8 payers, 21 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	Highmark medicare facility · fee schedule · outpatient	$6	$6	—	—	—	$6 – $6
2	Humana medicare facility · fee schedule · outpatient	$6	$6	—	—	—	$6 – $6
3	Aetna medicare facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
4	Cigna medicare facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
5	UnitedHealthcare medicare facility · fee schedule · outpatient	$7	$7	—	—	—	$7 – $7
6	Highmark medicaid facility · fee schedule · outpatient	$21	$21	—	—	—	$21 – $21
7	Cigna commercial facility · fee schedule · outpatient	$22	$22	—	—	—	$22 – $22
8	Highmark commercial facility · fee schedule · outpatient	$22	$22	—	—	—	$22 – $22
9	UnitedHealthcare commercial facility · fee schedule · outpatient	$43	$43	—	—	—	$43 – $43
10	Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$136	$147	$25	17%	—	$125 – $190
11	Aetna aco facility · percent of total billed charges · outpatientfrom % of charges	$406	$438	$76	17%	—	$373 – $568
12	Aetna aco facility · percent of total billed charges · inpatientfrom % of charges	$430	$464	$80	17%	—	$395 – $601
13	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$440	$475	$82	17%	—	$405 – $616
14	Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges	$486	$524	$91	17%	—	$447 – $680
15	Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges	$486	$524	$91	17%	—	$447 – $680
16	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$521	$562	$97	17%	—	$478 – $728
17	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$551	$594	$103	17%	—	$506 – $770
18	Carefirst commercial facility · percent of total billed charges · inpatientfrom % of charges	$608	$656	$114	17%	—	$558 – $850
19	Carefirst commercial facility · percent of total billed charges · outpatientfrom % of charges	$608	$656	$114	17%	—	$558 – $850
20	MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges	$608	$656	$114	17%	—	$558 – $850
21	MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges	$608	$656	$114	17%	—	$558 – $850

Last updated: Mar 6, 2026

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