00517-0710-01 — Fomepizole
Cite this view
HANK Price Transparency. (n.d.). FOMEPIZOLE (NDC 00517-0710-01) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/00517-0710-01?code_type=NDC
“FOMEPIZOLE (NDC 00517-0710-01) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/00517-0710-01?code_type=NDC. Accessed .
“FOMEPIZOLE (NDC 00517-0710-01) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/00517-0710-01?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,031–$3,823 (25th–75th percentile) across 4 hospitals · 16 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 00517-0710-01 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| LITTLETON REGIONAL HEALTHCARE Inpatient | Ambetter | Exchange | $720.50 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | New Hampshire Healthy Families | Medicaid | $964.24 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Boston Medical Center Health Plan Dba Well Sense | Boston Medical Center Health Plan Dba Well Sense | $1,912.08 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Amerihealth | Amerihealth | $1,912.08 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | United Healthcare Va Ccn | United Healthcare Va Ccn | $1,912.08 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Wellcare Medicare | Wellcare Medicare | $1,912.08 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Humana | Humana | $1,912.08 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Cigna Health And Life | Cigna Health And Life | $2,149.90 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Harvard Pilgrim Health Care | Marketplace | $2,670.56 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Harvard Pilgrim | Littleton Options | $2,888.87 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | United Healthcare Freedom Plan | Epo Ppo | $3,179.24 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Harvard Pilgrim Health Care | Elevate Health | $3,433.58 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Blue Cross Blue Shield | Tvhp | $3,497.17 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Blue Cross Blue Shield Vt | Managed | $3,539.56 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Anthem Blue Cross Blue Shield | Ppo | $3,539.98 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Anthem Blue Cross Blue Shield | Hmo Pos | $3,539.98 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Blue Cross Blue Shield Vt | Non Managed | $3,624.34 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Anthem Blue Cross Blue Shield | Fep | $3,711.66 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Harvard Pilgrim Health Care | All Other | $3,776.94 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Anthem Blue Cross Blue Shield | Indemnity | $3,789.23 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Aetna | Aetna | $3,857.48 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Multiplan | Multiplan | $4,027.04 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | United Healthcare | All Payer | $4,090.63 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| LITTLETON REGIONAL HEALTHCARE Inpatient | Coventry First Health | Coventry First Health | $4,154.21 | $4,238.99 | $2,458.61 | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTHCARE WHITE OAK MEDICAL CENTER Both | All Payers | All Plans | $4,678.87 | $4,678.87 | $4,585.29 | 2025-12-31 | MRF ↗ |
| ADVENTIST HEALTHCARE SHADY GROVE MEDICAL CENTER Both | All Payers | All Plans | $6,026.00 | $6,026.00 | $5,905.48 | 2025-12-31 | MRF ↗ |
| ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CTR Both | All Payers | All Plans | $7,210.42 | $7,210.42 | $7,066.21 | 2025-12-31 | MRF ↗ |