IV push, single drug at Providence Little Co of Mary Med Center San Pedro. CPT 96374.
What Providence Little Co of Mary Med Center San Pedro publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$215cash price (self-pay)
$613list price
$111–$970range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield | Epn/Ifp Benefit Exchange | $111 |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $120 |
| Blue Shield | Hmo | $134 |
| Blue Shield | Ppo/Epo | $134 |
| Blue Shield | Medicare Managed Care Plan | $214 |
| Aetna | Medicare Managed Care Plan | $274 |
| Humana | Medicare Managed Care Plan | $279 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $287 |
| Caremore | Medicare Managed Care Plan | $301 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $323 |
| La Care Health Plan | Covered Ca Exchange | $356 |
| Healthnet | Ambetter Hmo | $506 |
| Healthnet | Ambetter Ppo | $585 |
| Healthnet | Blue And Gold Other Commercial Plan | $601 |
| Healthnet | All Commercial Plans | $970 |
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All common services at Providence Little Co of Mary Med Center San Pedro