IV push, single drug at Mercy Hospital Fort Smith. CPT 96374.
What Mercy Hospital Fort Smith publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$137cash price (self-pay)
$210list price
$46.24–$337range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MERCY INTERFACILITY [20513] | HB FTSM Inter-Facility CCR New 6.1.25 | $46.24 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Bartel | $52.50 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Tall Tree | $52.50 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Schaefer Qcg | $52.50 |
| Aither Health Contracted [320449] | Hb Ftsm Dec Woodard | $52.50 |
| Aither Health Contracted [320449] | Hb Ftsm Dec Laclede - New 07.01.25 | $52.50 |
| United Healthcare [20396] | Hb Ftsm,Wldar,Ozkar,Prsar,Bnvr UHC | $78.00 |
| United Healthcare Contracted [320396] | Hb Ftsm,Wldar,Ozkar,Prsar,Bnvr | $78.00 |
| United Medical Resources Contracted [320454] | Hb Ftsm,Wldar,Ozkar,Prs | $78.00 |
| Optum Health Behavioral Solutions [520250] | Hb Ftsm,Wldar,Ozkar,Prsar | $78.00 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Show Me | $105 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Town And Country | $105 |
| 90 Degree Benefits Contracted [320436] | Hb Ftsm Dec Show Me | $105 |
| Cigna Healthcare Contracted [320071] | Hb Ftsm Cigna | $120 |
| Healthlink Contracted [320179] | Hb Ftsm Rogr Cah Dec Sapaugh | $126 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Rogr Dec Easter Seal | $126 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Rogr Dec City Of Jac | $126 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Rogr Cah Dec Sapaugh | $126 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Herman | $126 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Quiktrip Co | $126 |
| Ebms [20493] | Hb Ftsm Crader | $126 |
| Municipal Health Plan Contracted [320271] | Hb Ftsm Municipal Health | $126 |
| Auxiant Contracted [320462] | Hb Ftsm Rogr Dec Buchheit | $126 |
| Auxiant Contracted [320462] | Hb Ftsm Rogr Dec City Of Jackson | $126 |
| Personify Health Contracted [320051] | Hb Ftsm Net Affiliation | $137 |
| Healthlink Contracted [320179] | Hb Ftsm Net Affiliation | $137 |
| Workers Comp [20426] | Hb Ftsm Work Comp Aetna/Coventry | $137 |
| Auxiant Contracted [320462] | Hb Ftsm Net Affiliation | $137 |
| Insurance System Inc Contracted [320465] | Hb Ftsm Net Affiliation | $137 |
| Novasys Contracted [320285] | Hb Ftsm Novasys | $147 |
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