Fomepizole 1 gram/ml intravenous solution at Sanford Luverne Medical Center

1600 N Kniss Ave, Luverne, MN · Sanford Health · · NPI 1497703045

Source: hospital's published price file ↗ · Published Mar 4, 2026 · Ingested Aug 12, 2026

$974.40

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

Full explanation →

What you pay up front if you don't use insurance.

$1,218.00

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$268.00 with Blue Cross Blue Shield of Minnesota vs $1,047.22 with Medica — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
Blue Cross Blue Shield of Minnesota PMAP $268.00 ↓ -72%
Sanford Health Plan Align Medicare Replacement $389.66 ↓ -60%
Ucare Medicare Replacement $417.34 ↓ -57%
Blue Cross Blue Shield of Minnesota Medicare Replacement $421.77 ↓ -57%
Health Partners Medicare Replacement $421.77 ↓ -57%
Aetna Medicare Replacement $421.77 ↓ -57%
United Healthcare Medicare Replacement $421.77 ↓ -57%
Great Plains Medicare Advantage Medicare Replacement $421.77 ↓ -57%
Primewest Medicare Replacement $430.07 ↓ -56%
Primewest Medicaid Managed Care $523.61 ↓ -46%
Sanford Health Plan Group Health/True $593.13 ↓ -39%
Sanford Health Plan SD Exchange True $593.13 ↓ -39%
Security Health Plan Commercial $608.85 ↓ -38%
Sanford Health Plan SD Exchange Commercial $697.74 ↓ -28%
Sanford Health Plan Commercial/ND Pers $697.74 ↓ -28%
Health Partners State Employees $762.72 ↓ -22%
Health Partners Commercial $885.60 ↓ -9%
Blue Cross Blue Shield of Minnesota State Employees $905.53 ↓ -7%
United Healthcare Commercial + Top 20 $924.35 ↓ -5%
Aetna Commercial $961.98 ↓ -1%
Ucare Commercial $972.61 ↓ -0%
Medica Choice $973.05 ↓ -0%
Multiplan Commercial $996.30 ↑ +2%
Healthez Commercial $996.30 ↑ +2%
First Choice Health Network Commercial $996.30 ↑ +2%
Cigna Commercial $996.30 ↑ +2%
Blue Cross Blue Shield of Minnesota Commercial/Federal $1,024.20 ↑ +5%
Medica Elect $1,047.22 ↑ +7%
Ucare Medicaid Managed Care not published by hospital —

Visitor-reported prices

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Fomepizole 1 gram/ml intravenous solution at other Minnesota hospitals

Hospital City Cash price Negotiated range
Sanford Westbrook Hospital Westbrook $871.20 $263.65 – $980.10
Sanford Bemidji Medical Center Bemidji $1,658.51 $5.96 – $660.38
Sanford Worthington Medical Center Worthington $1,526.40 $5.96 – $745.20
Sanford Tracy Hospital Tracy $804.56 $243.48 – $905.13
Sanford Thief River Falls Medical Center Thief River Falls $1,594.03 $655.06 – $1,716.33
Sanford Behavioral Health Thief River Falls Thief River Falls $1,594.03 $655.06 – $1,716.33
United Hospital MN | 1175 Nininger Road. Hastings $1,503.13 $6.11 – $20.92
Owatonna Hospital Owatonna $1,924.23 $6.11 – $1,295.08

All Minnesota hospitals for this procedure →