IV push, single drug at Good Samaritan Hospital. CPT 96374.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$868cash price (self-pay)
$891list price
$49.82–$1,418range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Physicians Medical Group | MCD | $49.82 |
| Anthem | Medi-Cal | $54.80 |
| Physician Health Network | MGMCD | $54.80 |
| MedCare Partners | MGMCR | $134 |
| Santa Clara Family Health Plan | Medicaid | $169 |
| Bright Health | COMM | $179 |
| Aetna | AWH | $185 |
| Aetna | HMO | $189 |
| Aetna | PPO | $189 |
| Health Net | COMM | $207 |
| Cigna | LocalPlus | $207 |
| Cigna | HMO | $220 |
| Cigna | POS | $220 |
| Cigna | PPO | $220 |
| United | OptionsPPO | $227 |
| United | GlobalBenefitPlan | $401 |
| Santa Clara IPA COMM | COMM | $445 |
| Santa Clara IPA MCR | MCR | $445 |
| NX Health Network | COMM | $534 |
| Sutter Select | COMM | $534 |
| Blue Shield | COMM | $540 |
| Blue Shield | EPN | $540 |
| MultiPlan | Primary | $579 |
| ChoiceCare Humana | COMM | $624 |
| First Health | COMM | $677 |
| Cigna BH | COMMBH | $713 |
| HealthSmart | WCOMP | $713 |
| Intercontinental Corporation | COMM | $713 |
| MultiPlan | Complementary | $713 |
| PHA Pacific Health Alliance | COMM | $713 |
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