Fomepizole 1 gram/ml intravenous solution at UPMC Chautauqua

207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222

Source: hospital's published price file ↗ · Published unknown · Ingested Aug 13, 2026

$2,932.80

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.

$4,888.00

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.

$6.28 with United Healthcare vs $41.40 with Affordable First Health — 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
United Healthcare Medicare $6.28 ↓ -100%
Humana Medicare $6.28 ↓ -100%
Beacon Medicare Advantage $6.28 ↓ -100%
UPMC Health Plan Managed Medicare $6.28 ↓ -100%
Fidelis Medicare $6.28 ↓ -100%
UNITED BEHAVIORAL HEALTH MEDICARE $6.28 ↓ -100%
UPMC Health Plan EPO Partners/EPO Select Plan/HMO $6.41 ↓ -100%
Wellcare Medicare $6.47 ↓ -100%
Aetna Medicare $6.53 ↓ -100%
Beacon Commercial $7.85 ↓ -100%
Independent Health Medicare Advantage $15.30 ↓ -99%
Independent Health Commercial $15.30 ↓ -99%
BCBS of Western NY Commercial $15.75 ↓ -99%
Univera Medicare Advantage $15.90 ↓ -99%
Geisinger Medicaid/CHIP $25.30 ↓ -99%
UPMC Health Plan Commercial $27.60 ↓ -99%
United Healthcare Commercial $29.44 ↓ -99%
Aetna Commercial $29.90 ↓ -99%
Humana Commercial $34.50 ↓ -99%
MagnaCare Workers Compensation $34.50 ↓ -99%
MagnaCare Direct Plus $34.50 ↓ -99%
MagnaCare PPO $34.50 ↓ -99%
Multiplan PPO (Includes PHCS as a Payer) $34.50 ↓ -99%
MagnaCare No Fault $34.50 ↓ -99%
GHI/Emblem Health Commercial $36.80 ↓ -99%
Statewide Independent PPO PPO $40.48 ↓ -99%
Affordable First Health PPO $41.40 ↓ -99%
Tricare East Region not published by hospital
US Family Health Plan Tricare Prime not published by hospital

Visitor-reported prices

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Fomepizole 1 gram/ml intravenous solution at other New-york hospitals

Hospital City Cash price Negotiated range
NewYork-Presbyterian Queens Flushing $1,229.06 $5.73 – $295.96
NewYork-Presbyterian Hudson Valley Hospital Cortlandt Manor $1,229.06 $5.72 – $295.67
NewYork-Presbyterian Columbia University Irving Medical Center New York $1,229.06 $5.73 – $248.47

All New-york hospitals for this procedure →