IV push, single drug at Southeast Iowa Regional Medical Center West Burlington. CPT 96374.
What Southeast Iowa Regional Medical Center West Burlington publishes for this service, straight from its standard-charges file, last updated June 11, 2026.
Outpatient / ER
—cash price (self-pay)
$397list price
$27.97–$369range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| American Healthplan of Iowa - Midlevel | MEDICARE ADV. | $27.97 |
| Wellmark Blue Cross | HMO | $33.95 |
| Humana | MEDICARE ADV. | $34.46 |
| Wellmark Blue Cross | PPO | $37.28 |
| American Healthplan of Iowa - MD | MEDICARE ADV. | $38.17 |
| Medicaid - Nurse Practitioner | MANAGED MEDICAID | $38.82 |
| Medicaid - Physician Assistant | MANAGED MEDICAID | $39.65 |
| Medicaid - Physician | MANAGED MEDICAID | $45.67 |
| Aetna | FIRST HEALTH | $51.99 |
| Wellmark Blue Cross - Anesthesiology | PPO | $66.20 |
| Wellmark Blue Cross - Pathologist | PPO | $66.20 |
| Elap | Primary | $72.55 |
| Elap | Specialty | $82.91 |
| Plain Church | ALL PRODUCTS | $83.20 |
| United Healthcare | ALL PRODUCTS | $86.15 |
| Midlands Choice | ALL PRODUCTS | $90.60 |
| Elap | Anesthesia | $104 |
| Absolute Solutions | ALL PRODUCTS | $115 |
| First Agency | ALL PRODUCTS | $115 |
| Multiplan | ALL PRODUCTS | $115 |
| Henderson County | ALL PRODUCTS | $122 |
| Immergrun | ALL PRODUCTS | $137 |
| 6 Degree | ALL PRODUCTS | $174 |
| Wellpoint (Amerigroup) | Managed Medicaid | $222 |
| Immugrun | All Products | $250 |
| Brighton Amish Church | All Products | $258 |
| Plain Church | All Products | $258 |
| 6 Degree | All Products | $318 |
| Midlands Choice | All Products | $337 |
| Geha | PPO | $369 |
Inpatient
—cash price (self-pay)
$397list price
$222–$369range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Midlands Choice | All Products | $357 |
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All common services at Southeast Iowa Regional Medical Center West Burlington