FOMEPIZOLE INJ 1 GM/ML (FOR IV INFUSION) - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|
| Medical Center Enterprise | Enterprise, AL | $0.09 | $0.85 | $1.04 | $0.09 - $460 |
| Crestwood Medical Center | Huntsville, AL | $7.48 | $16.63 | $41.58 | $6.43 - $535 |
| Mat-Su Regional Medical Center | Palmer, AK | $12.30 | $31.16 | $41.00 | $4.40 - $41.00 |
| Gadsden Regional Medical Center | Gadsden, AL | $8.70 | $38.64 | $72.50 | $6.44 - $1,525 |
| Grandview Medical Center | Birmingham, AL | $16.35 | $54.50 | $109 | $6.44 - $607 |
| Flowers Hospital | Dothan, AL | $19.13 | $80.98 | $128 | $6.44 - $498 |
| Kadlec Regional Medical Center | Richland, WA | $1,225 | - | $1,751 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $1,301 | - | $2,710 | - |
| Providence St. Joseph Medical Center | Polson, MT | $1,316 | - | $1,646 | - |
| St. Patrick Hospital | Missoula, MT | $1,316 | - | $1,646 | - |
| Providence Holy Family Hospital | Spokane, WA | $1,337 | - | $1,910 | - |
| Providence Mount Carmel Hospital | Colville, WA | $1,337 | - | $1,910 | - |
| Healdsburg Hospital | Healdsburg, CA | $1,534 | - | $3,007 | - |
| Providence Redwood Memorial Hospital | Fortuna, CA | $1,534 | - | $3,007 | - |
| Petaluma Valley Hospital | Petaluma, CA | $1,534 | - | $3,007 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $1,534 | - | $3,007 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $1,573 | - | $3,277 | - |
| St. Mary Medical Center | Long Beach, CA | $1,586 | - | $3,304 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $1,803 | - | $2,405 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $1,835 | - | $5,242 | - |
| Providence Portland Medical Center | Portland, OR | $1,862 | - | $2,482 | - |
| Providence Centralia Hospital | Centralia, WA | $1,867 | - | $3,591 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $2,158 | - | $6,166 | - |
| Providence Newberg Medical Center | Newberg, OR | $2,222 | - | $2,963 | - |
| Providence Medford Medical Center | Medford, OR | $2,222 | - | $2,963 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $2,228 | - | $6,366 | - |
| Providence Seaside Hospital | Seaside, OR | $2,241 | - | $2,988 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $2,241 | - | $2,988 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $2,282 | - | $2,925 | - |
| Providence Alaska Medical Center | Anchorage, AK | $2,282 | - | $2,925 | - |
| Providence Regional Medical Center Everett | Everett, WA | $2,301 | - | $4,426 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $2,512 | - | $5,233 | - |
| Swedish Issaquah | Issaquah, WA | $2,512 | - | $5,233 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $2,581 | - | $3,687 | - |
| Providence St. Joseph Hospital | Eureka, CA | $2,603 | - | $5,423 | - |
| Providence Valdez Medical Center | Valdez, AK | $2,771 | - | $3,552 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $2,860 | - | $4,086 | - |
| Providence St. Peter Hospital | Olympia, WA | $2,923 | - | $5,622 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $2,960 | - | $3,947 | - |
| Providence St. Vincent Medical Center | Portland, OR | $3,282 | - | $4,377 | - |
| Saint John'S Health Center | Santa Monica, CA | $3,543 | - | $10,122 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $3,696 | - | $8,800 | - |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $3,928 | - | $11,223 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $3,928 | - | $11,223 | - |
| Covenant Medical Center | Lubbock, TX | $5,959 | - | $14,189 | - |
Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.