Price of Fomepizole IV Solution at NYU Langone
Last Updated: 2024-07-01
Locations
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NYU Langone|Tisch Hospital
550 1st Ave., New York, NY 10016About Fomepizole IV Solution
Service Codes: LOCAL 5010015, HCPCS J1451
This procedure involves administering Fomepizole, a medication given intravenously to treat methanol or ethylene glycol poisoning. It works by inhibiting the enzyme that breaks down these toxic substances in the body, helping to prevent serious health complications.
Pricing Overview
Cash Price
$17.29
Median Price
$27.31
Price Range
$7.22 - $725.01
Insurance Plan Prices
| Insurance Provider | Plan Type | Price |
|---|---|---|
| Blue Cross Blue Shield | Global Transplants | $16.50 |
| Fidelis Care | Silver 250 (Exchange) | $609.82 |
| EmblemHealth | GHI Behavioral Management Program | $10.93 |
| Blue Cross Blue Shield | Blue Access EPO (Large Group) | $16.50 |
| UnitedHealthcare | Navigate | $9.57 |
| MultiPlan | Screen Actors Guild | $71.00 |
| Aetna | Open Access HMO | $54.61 |
| UnitedHealthcare | POMCO (UMR) | $71.00 |
| Healthfirst | Silver Leaf (Exchange) | $698.58 |
| EmblemHealth | WLNY-TV | $10.93 |
| EmblemHealth | HIP compre health epo | $14.47 |
| EmblemHealth | Essential Plan 3 | $338.79 |
| HealthSmart | WTC Health Program - Mt. Sinai | $7.22 |
| Blue Cross Blue Shield | PPO/EPO (Small Group) | $16.50 |
| VNS Health | EasyCare Plus (Medicare+Medicaid) | $7.22 |
| Healthfirst | Gold Leaf (Exchange) | $698.58 |
| Blue Cross Blue Shield | Local 32 BJ | $16.50 |
| EmblemHealth | Vytra HMO | $14.47 |
| EmblemHealth | GHI Medicare Supplement | $7.22 |
| BCBS (Out of State) | PPO | $16.50 |
| Anthem BCBS HealthPlus | Special Needs Plan (SNP) | $338.79 |
| MultiPlan | Healthnet of California | $71.00 |
| MultiPlan | PHCS | $71.00 |
| Blue Cross Blue Shield | Open Access HMO (Home-based Only) | $16.50 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) Select/Extra HMO (HCP) | $7.22 |
| EmblemHealth | HIP Long Island College Hospital (LICH) | $14.47 |
| UnitedHealthcare | HMO | $9.57 |
| Anthem BCBS HealthPlus | SOMOS ny medicaid | $355.73 |
| BCBS (Out of State) | EPO (No Suitcase Logo) | $16.50 |
| EmblemHealth | HIP VIP Medicare Bold | $7.22 |
| Blue Cross Blue Shield | Blue Access gEPO (Large Group) | $16.50 |
| Fidelis Care | Gold for Children (Exchange) | $609.82 |
| Blue Cross Blue Shield | Blue Access EPO (Small Group) | $16.50 |
| EmblemHealth | CMO Essential Plan 4 | $338.79 |
| Blue Cross Blue Shield | Pathway | $18.36 |
| MultiPlan | Mutual of Omaha | $71.00 |
| MetroPlus | Child Health Plus (CHP) | $338.79 |
| Fidelis Care | Silver (Exchange) | $609.82 |
| EmblemHealth | Enhanced Care (Medicaid) Montefiore | $338.79 |
| UnitedHealthcare | Medicare Advantage | $7.22 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) HMO (HCP) | $7.22 |
| UnitedHealthcare | AARP Medicare Advantage Complete Mosaic | $7.22 |
| EmblemHealth | Enhanced Care (Medicaid) Child Health Plus (SOMOS) | $355.73 |
| Anthem BCBS | All Plans | $16.50 |
| EmblemHealth | Healthcare Partners Essential Plan 3 | $338.79 |
| Blue Cross Blue Shield | Pathway X Enhanced | $18.36 |
| EmblemHealth | American Plan Administrators | $10.93 |
| BCBS (Out of State) | Indemnity | $16.50 |
| Anthem BCBS HealthPlus | Medicaid | $338.79 |
| EmblemHealth | CMO Essential Plan 2 | $406.55 |
| MultiPlan | AXA Global Insurance | $71.00 |
| Anthem BCBS HealthPlus | All Exchange Plans | $18.36 |
| MultiPlan | PPO | $71.00 |
| EmblemHealth | HIP Medicare Supplement | $7.22 |
| UnitedHealthcare | POS | $9.57 |
| Fidelis Care | Bronze (Exchange) | $609.82 |
| UnitedHealthcare | Independent | $9.57 |
| UnitedHealthcare | AARP Medicare Advantage Complete | $7.22 |
| UnitedHealthcare | PPO | $9.57 |
| Blue Cross Blue Shield | UniCare | $16.50 |
| EmblemHealth | Bridge | $14.47 |
| BCBS (Out of State) | HMO (No Suitcase Logo) | $16.50 |
| Partners Health Plan | FIDA | $7.22 |
| EmblemHealth | HIP VIP Medicare Healthcare Partners | $7.22 |
| Aetna | Indemnity | $7.22 |
| Fidelis Care | Platinum (Exchange) | $609.82 |
| MultiPlan | Meritain Health | $71.00 |
| Blue Cross Blue Shield | Blue Priority HMO | $16.50 |
| Blue Cross Blue Shield | Open Access PPO (Home-based Only) | $16.50 |
| Cigna | HMO | $27.31 |
| EmblemHealth | GHI Medicare HMO | $7.22 |
| UnitedHealthcare | Golden Rule Insurance | $9.57 |
| Cigna | Great West HMO | $27.31 |
| Cigna | Wellfleet Student | $27.31 |
| UnitedHealthcare - Oxford | Medicare Advantage | $7.22 |
| EmblemHealth | Healthcare Partners Essential Plan 3-4 | $338.79 |
| EmblemHealth | Enhanced Care (Medicaid) | $338.79 |
| Blue Cross Blue Shield | Senior Care Supplemental | $7.22 |
| Three Rivers | All Plans (Home-based Only) | $81.92 |
| MultiPlan | Diversified Admin Corp | $71.00 |
| EmblemHealth | HIP VIP Medicare Affinity | $7.22 |
| Fidelis Care | Medicaid Managed Care | $420.10 |
| Blue Cross Blue Shield | Child Health Plus (CHP) | $338.79 |
| VNS Health | EasyCare (Medicare Advantage) | $7.22 |
| EmblemHealth | HIP SmartStart | $14.47 |
| MetroPlus | Essential Plan 2 | $338.79 |
| Elderplan | FIDA | $7.22 |
| UnitedHealthcare | Core | $9.57 |
| VNS Health | MLTC (Medicaid) | $294.77 |
| Blue Cross Blue Shield | Blue Access PPO (Large Group) | $16.50 |
| Fidelis Care | Essential Plan 4 | $420.10 |
| Blue Cross Blue Shield | PPO | $16.50 |
| MultiPlan | Teamsters Allied Benefits | $71.00 |
| BCBS (Out of State) | PPO (No Suitcase Logo) | $16.50 |
| UnitedHealthcare | Charter | $9.57 |
| Centers Plan for Healthy Living | All Plans | $7.22 |
| Veterans Choice | Veterans Choice Program | $7.22 |
| Blue Cross Blue Shield | Blue Priority PPO | $16.50 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 1 & 200-250 | $457.37 |
| Aetna | HMO | $54.61 |
| UnitedHealthcare - Oxford | Optum Health | $11.91 |
| First Health | PPO | $71.00 |
| EmblemHealth | HIP VIP Medicare Reserve | $7.22 |
| GEHA | All Plans | $54.61 |
| MultiPlan | Global Excel Management | $71.00 |
| EmblemHealth | Enhanced Care (Medicaid) (SOMOS) | $355.73 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 1, 200-250 (SOMOS) | $457.37 |
| MetroPlus | Essential Plan 3-4 | $338.79 |
| EmblemHealth | HIP EPO | $14.47 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 2 | $457.37 |
| Anthem BCBS | Empire Plan, Value Options | $16.50 |
| Health Net | PPO | $71.00 |
| Fidelis Care | Essential Plan 3 | $420.10 |
| EmblemHealth | HIP compre health | $14.47 |
| Aetna | Medicare Advantage | $7.22 |
| Aetna | Allied ASA PPO | $54.61 |
| EmblemHealth | Enhanced Care (Medicaid) SNP HARP (SOMOS) | $355.73 |
| Healthfirst | Essential Plan 1 | $698.58 |
| EmblemHealth | American Plan Administrators c/o H.D.A | $10.93 |
| Champus | Unysis Corp | $7.22 |
| UnitedHealthcare - Oxford | Freedom | $11.91 |
| Aetna | Signature Administrators PPO | $54.61 |
| HealthSmart | WTC Health Program - Logistic Health Inc | $7.22 |
| EmblemHealth | Healthcare Partners Essential Plan 4 | $338.79 |
| Cigna | MVP-Cigna Network | $27.31 |
| Blue Cross Blue Shield | Indemnity | $16.50 |
| Maksin Group | Consolidated Health Plan (Home-based only) | $27.31 |
| BCBS (Out of State) | PPO (Suitcase Logo) | $16.50 |
| Aetna | Student Health | $54.61 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) HMO | $7.22 |
| BCBS (Out of State) | Medicare (No Suitcase Logo) | $7.22 |
| Cigna | PPO | $27.31 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) PPO | $7.22 |
| EmblemHealth | HIP Access II | $14.47 |
| UnitedHealthcare | AARP Medicare Advantage Complete Essentials | $7.22 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 3 | $355.73 |
| EmblemHealth | Healthcare Partners Essential Plan 1, 200-250 | $406.55 |
| UnitedHealthcare | AARP | $7.22 |
| Anthem BCBS HealthPlus | Medicare Advantage | $7.22 |
| CenterLight | PACE Medicare HMO | $7.37 |
| MetroPlus | Essential Plan 1 | $338.79 |
| Blue Cross Blue Shield | Blue Access EPO (Large Group) (NY LI Local 1199SEIU) | $16.50 |
| EmblemHealth | HIP PPO | $14.47 |
| EmblemHealth | Healthcare Partners Essential Plans | $406.55 |
| Aetna | POS | $54.61 |
| BCBS (Out of State) | HMO | $16.50 |
| BCBS (Out of State) | EPO (Suitcase Logo) | $16.50 |
| UnitedHealthcare | Choice (North Shore - LIJ) | $9.57 |
| BCBS (Out of State) | HMO (Suitcase Logo) | $16.50 |
| MetroPlus | BronzePlus | $14.30 |
| VA Community Care Network | Optum | $7.22 |
| MultiPlan | US Life Insurance Co | $71.00 |
| Aetna | Chesterfield Resources ASA PPO | $54.61 |
| Aetna | PPO | $54.61 |
| Blue Cross Blue Shield | Blue Priority EPO (Small Group) | $16.50 |
| HealthSmart | WTC Health Program - FDNY | $7.22 |
| Aetna | Healthscope ASA PPO | $54.61 |
| EmblemHealth | HIP | $14.47 |
| Blue Cross Blue Shield | Pathway Enhanced | $18.36 |
| Cigna | NALC PPO | $27.31 |
| Fidelis Care | Child Health Plus (CHP) | $420.10 |
| EmblemHealth | Essential Plan 1, 200-250 | $406.55 |
| Fidelis Care | Wellcare Medicare Advantage | $7.22 |
| 1199SEIU Funds | PPO | $39.20 |
| MultiPlan | Nippon Life | $71.00 |
| EmblemHealth | HIP VIP Medicare Montefiore | $7.22 |
| Anthem BCBS HealthPlus | SOMOS Special Needs HARP | $355.73 |
| Aetna | Open Access Elect Choice EPO | $54.61 |
| MultiPlan | Guardian Life Insurance Co | $71.00 |
| EmblemHealth | CMO Essential Plan 1 | $406.55 |
| HealthSmart | WTC Health Program - NYCHHC | $7.22 |
| BCBS (Out of State) | EPO | $16.50 |
| Aetna | Meritain Health | $54.61 |
| EmblemHealth | GHI HMO | $10.93 |
| Healthfirst | Platinum Leaf (Exchange) | $698.58 |
| EmblemHealth | BCBS GHI Composite | $16.50 |
| Cigna | Great West PPO | $27.31 |
| Cigna | Indemnity | $27.31 |
| Anthem BCBS HealthPlus | Essential Plan 4 | $338.79 |
| Cigna | LifeSOURCE | $27.31 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 2 (SOMOS) | $457.37 |
| Horizon BCBS | Direct | $16.50 |
| MetroPlus | GoldCare 2 | $725.01 |
| Carelon Behavioral Health | Medicaid Managed Care (Home-based Only) | $294.77 |
| EmblemHealth | HIP Optum Health | $14.47 |
| Cigna | Cigna Managed Care/POS | $27.31 |
| EmblemHealth | HIP Montefiore | $14.47 |
| Aetna | Nippon Life ASA PPO | $54.61 |
| Blue Cross Blue Shield | Federal Program | $16.50 |
| EmblemHealth | Enhanced Care (Medicaid) Healthcare Partners | $338.79 |
| BCBS (Out of State) | POS (No Suitcase Logo) | $16.50 |
| MultiPlan | PHCS Savility | $71.00 |
| MultiPlan | Global Health Management | $71.00 |
| Aetna | Global National Transplant | $54.61 |
| Aetna | Christian Brothers ASA PPO | $54.61 |
| UnitedHealthcare | Choice | $9.57 |
| Fidelis Care | Essential Plan 2 | $20.70 |
| UnitedHealthcare - Oxford | Liberty | $11.91 |
| EmblemHealth | HIP Access I | $14.47 |
| UnitedHealthcare | Medicare Advantage Complete Choice Regional PPO | $7.22 |
| MetroPlus | Gold | $725.01 |
| AgeWell (Deprecated) | Medicaid Managed Care | $294.77 |
| MultiPlan | PHP Healthcare (Champus) | $71.00 |
| EmblemHealth | VIP Prime HMO Medicare Advantage | $7.22 |
| Anthem BCBS HealthPlus | Essential Plan 1, 200-250 | $677.58 |
| HealthSmart | WTC Health Program - UMDNJ Rutgers | $7.22 |
| Healthfirst | Personal Wellness Plan (HARP) | $294.77 |
| Partners Health Plan | Medicare Advantage | $7.22 |
| Healthfirst | Bronze Leaf (Exchange) | $698.58 |
| MetroPlus | Medicare Advantage | $7.22 |
| Elderplan | All Plans | $7.22 |
| BCBS (Out of State) | Medicare (Suitcase Logo) | $7.22 |
| EmblemHealth | HIP Child Health Plus | $338.79 |
| Aetna | Coresource ASA PPO | $54.61 |
| VillageCareMAX | All Plans | $7.22 |
| EmblemHealth | Essential Plan 2 | $406.55 |
| EmblemHealth | HIP HMO | $14.47 |
| Cigna | Tufts Health Plan | $27.31 |
| BCBS (Out of State) | POS | $16.50 |
| EmblemHealth | Healthcare Partners Essential Plan 2 | $406.55 |
| CenterLight | Select | $7.37 |
| EmblemHealth | HIP POS | $14.47 |
| UnitedHealthcare | Optum Health | $9.57 |
| First Health | Commercial HMO | $76.46 |
| Anthem BCBS | Optum | $16.50 |
| UnitedHealthcare | Student Resources | $9.57 |
| 1199SEIU Funds | Member Choice Home Care Select | $39.20 |
| Fidelis Care | Bronze for Children (Exchange) | $609.82 |
| HealthSmart | WTC Health Program - NYU | $7.22 |
| UnitedHealthcare | Choice (NY Power Authority) | $9.57 |
| EmblemHealth | GHI EPO | $10.93 |
| Aetna | Starmark ASA PPO | $54.61 |
| Partners Health Plan | Medicare Advantage (Home-based Only) | $7.22 |
| MetroPlus | SilverPlus | $14.30 |
| MultiPlan | Principal Financial Group | $71.00 |
| Fidelis Care | Gold (Exchange) | $609.82 |
| Aetna | Wellnet ASA PPO | $54.61 |
| EmblemHealth | HIP Healthcare Partners HMO | $14.47 |
| UnitedHealthcare | POMCO (UMR) | $9.57 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 3 (SOMOS) | $355.73 |
| CenterLight | PACE | $7.37 |
| MultiPlan | Kaiser Permanente | $71.00 |
| Sedgwick | WTC Health Program - Northwell | $7.22 |
| Partners Health Plan | Medicaid MLTC | $294.77 |
| Blue Cross Blue Shield | HMO | $16.50 |
| BCBS (Out of State) | Medicare | $7.22 |
| Blue Cross Blue Shield | Blue Connection | $16.50 |
| Anthem BCBS HealthPlus | SOMOS Child Health Plus (CHP) | $355.73 |
| EmblemHealth | GHI Comprehensive Benefits Plan (CBP) | $10.93 |
| EmblemHealth | GHI Medicare PPO | $7.22 |
| Blue Cross Blue Shield | Healthy New York | $16.50 |
| UnitedHealthcare | EPO | $9.57 |
| MultiPlan | Humana Health Plan | $71.00 |
| Healthfirst | Essential Plan 1-2, 200-250 | $698.58 |
| Anthem BCBS HealthPlus | Essential Plan 3 | $338.79 |
| MultiPlan | QualCare Inc | $71.00 |
| Fidelis Care | Silver for Children (Exchange) | $609.82 |
| Cigna | Open Access | $27.31 |
| Cigna | Open Access PPO | $27.31 |
| Carelon Behavioral Health | All Exchange Plans (Home-based Only) | $7.22 |
| Blue Cross Blue Shield | Blue Access HMO (Small Group) | $16.50 |
| MultiPlan | Paramount Insurance | $71.00 |
| EmblemHealth | GHI PPO | $10.93 |
| EmblemHealth | CMO Essential Plan 3 | $338.79 |
| Fidelis Care | Catastrophic (Exchange) | $609.82 |
| Better Health Plan | All Plans | $76.46 |
| Blue Cross Blue Shield | Blue Access gEPO (Small Group) | $16.50 |
| Fidelis Care | Platinum for Children (Exchange) | $609.82 |
| EmblemHealth | GHI composite | $10.93 |
| Humana | All Commercial Plans | $71.00 |
| MetroPlus | Medicaid Managed Care | $338.79 |
| Carelon Behavioral Health | Medicare Advantage (Home-based Only) | $7.22 |
| Cigna | Open Access HMO | $27.31 |
| Blue Cross Blue Shield | EPO | $16.50 |
| EmblemHealth | IUOE Local 14-14B | $10.93 |
| MetroPlus | Essential Plan 4 | $338.79 |
| Blue Cross Blue Shield | MediBlue (Medicare Advantage) Select HMO/Extra HMO | $7.22 |
| Fidelis Care | Essential Plan 1 | $20.70 |
| MultiPlan | PHCS Director Guild | $71.00 |
| EmblemHealth | Enhanced Care (Medicaid) Essential Plan 4 (SOMOS) | $355.73 |
| VNS Health | SelectHealth (Medicaid) | $294.77 |
| Anthem BCBS HealthPlus | Essential Plan 2 | $677.58 |
| EmblemHealth | Essential Plan 4 | $338.79 |
| MetroPlus | PlatinumPlus | $14.30 |
| MultiPlan | Fiserv Health | $71.00 |
| EmblemHealth | Healthcare Partners Essential Plan 1-2 | $406.55 |
| UnitedHealthcare - Oxford | Metro | $11.91 |
| MetroPlus | GoldPlus | $14.30 |
| Blue Cross Blue Shield | Hotel Trades Council | $16.50 |
| Riverspring Health Plans | Medicare Advantage | $7.22 |
| Cigna | Premier Plus | $27.31 |
| Anthem BCBS HealthPlus | SOMOS Essential Plan 4 | $355.73 |
| VNS Health | Total (Medicare + Medicaid) | $7.22 |
| Anthem BCBS HealthPlus | Child Health Plus (CHP) | $338.79 |
| BCBS (Out of State) | POS (Suitcase Logo) | $16.50 |
| Hamaspik | Medicare Advantage | $10.84 |
| UnitedHealthcare | WTC Health Program | $7.22 |
| MultiPlan | Administrative Concepts | $71.00 |
| Partners Health Plan | Medicaid | $294.77 |
| MetroPlus | MedPlus | $14.30 |
| CenterLight | Direct | $7.37 |
| HealthSmart | WTC Health Program - Stony Brook | $7.22 |
| 1199SEIU Funds | Home Care Benefit Fund | $39.20 |
| Healthfirst | Green Leaf (Exchange) | $698.58 |
| MultiPlan | Capital District Physicians Health Plan | $71.00 |
| MetroPlus | Essential Plan 3 | $338.79 |
| Healthfirst | Essential Plan 2 | $698.58 |
| MetroPlus | Essential Plan 1-2, 200-250 | $338.79 |
| Senior Whole Health | All Plans | $7.22 |
| AgeWell (Deprecated) | Medicare Advantage | $7.22 |
| Fidelis Care | Native American (Exchange) | $609.82 |
| Anthem BCBS HealthPlus | Family Health Plus (Deprecated) | $338.79 |
| HealthSmart | WTC Health Program - Northwell | $7.22 |
| Cigna | Evernorth Behavioral Health | $27.31 |
| Blue Cross Blue Shield | POS | $16.50 |