IV push, single drug at San Gabriel Valley Medical Center. CPT 96374.
What San Gabriel Valley Medical Center publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
$143cash price (self-pay)
$477list price
$1.00–$3,548range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield of California | Blue Shield Value Network Covered Californ | $1.00 |
| AHMC Medi-Cal Reciprocity | AHMC Medi-Cal Reciprocity | $49.82 |
| AIDS Healthcare Foundation | AIDS Hlth Fndn/Positive Hlth Mcal | $49.82 |
| Allied Physicians | Allied Physicians Medi-Cal | $49.82 |
| AltaMed Health Network | AltaMed Health Network Medi-Cal | $49.82 |
| Avanti | Avanti Medi-cal | $49.82 |
| Beverly Hospital | BEVERLY HOSPITAL MCL | $49.82 |
| Emanate Health | Emanate Health Medi-Cal | $49.82 |
| HealthNet Medi-Cal Non-Contract | Health Net Medi-Cal | $49.82 |
| Healthy Way LA | Healthy Way LA | $49.82 |
| Hollywood Presbyterian Adv Med Mcal | Hollywood Presbyterian Adv Med M | $49.82 |
| Hollywood Presbyterian Medpoint Mcal | Hollywood Presbyterian Medpoint | $49.82 |
| Blue Cross Medi-Cal Managed Care | Blue Cross Healthy Families | $54.80 |
| LA Care Health Plan | LA Care Healthy Kids and Medi-Cal Managed Care | $57.29 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH PLAN MCAL | $69.75 |
| Blue Cross Medi-Cal Managed Care | Blue Cross Medi-Cal | $72.90 |
| Care 1st Health Plan | Care 1st Health Plan Healthy Families | $119 |
| AHMC Reciprocity | AHMC Reciprocity Commercial | $143 |
| AHMC Reciprocity | AHMC Reciprocity Sr | $143 |
| United Healthcare Senior Medicare Advantage | United Healthcare Senior | $155 |
| Alignment Healthplan | Alignment Healthplan Allied Pacific Sr Cap | $167 |
| Brand New Day | Brand New Day Allied Pacific SR Cap | $167 |
| Clever Care | Clever Care Accountable Phys Cap | $167 |
| Clever Care | Clever Care Allied Phys Cap | $167 |
| AIDS Healthcare Foundation | AIDS Healthcare Foundation | $191 |
| Health Net | Health Net Enhanced PPO | $230 |
| Facey Medical | Facey Medical | $239 |
| Aetna Health of California | Aetna | $248 |
| Health Net | Health Net Healthy Families/Kids/AIM | $277 |
| Central Health Plan | Central Health Plan HMO | $286 |
Inpatient
$143cash price (self-pay)
$477list price
$382–$477range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Beech Street | Beech Street PPO | $382 |
| MultiPlan | MultiPlan PPO | $429 |
| PPO Next | PPO Next | $429 |
| Other Non Contracted Commercial | Other Non Contracted Commercial | $477 |
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