IV push, single drug at St. Luke's Jerome Standard Charges. CPT 96374.
What St. Luke's Jerome Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$734cash price (self-pay)
$734list price
$94.99–$697range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commercial [1028] | Hb Mv Va Ccn | $166 |
| Veterans Affairs [1056] | Hb Mv Va Ccn | $166 |
| Blue Cross/Medicare Advantage [1009] | Hb Mv Bci True & Secure Med Adv | $240 |
| Medicare Advantage Aetna [1017] | Hb Mv Aetna Med Adv | $261 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $343 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $343 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $343 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $419 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $419 |
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $444 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $544 |
| Commercial [1028] | Hb Mv Slhp Select Health | $544 |
| Commercial [1028] | Hb Mv H2b | $551 |
| H2b [1068] | Hb Mv H2b | $551 |
| Pacificsource [1020] | Hb Mv Pacificsource PPO Voyager | $551 |
| Aetna [1021] | Hb Mv Bp Aetna | $587 |
| Cigna [1062] | Hb Mv Cigna | $587 |
| Commercial [1028] | Hb Mv Bp Aetna | $587 |
| Commercial [1028] | Hb Mv Cigna | $587 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $587 |
| Providence [1022] | Hb Mv Cigna | $587 |
| Webtpa [1071] | Hb Mv Bp Aetna | $587 |
| Commercial [1028] | Hb Mv Amps | $624 |
| Commercial [1028] | Hb Mv Christian Health Aid | $624 |
| Commercial [1028] | Hb Mv First Choice Health | $624 |
| First Health [1064] | Hb Mv First Choice Health | $624 |
| Webtpa [1071] | Hb Mv First Choice Health | $624 |
| Commercial [1028] | Hb Mv Moda Commercial | $646 |
| Moda [1055] | Hb Mv Moda Commercial | $646 |
| Blue Cross Out Of State [1041] | Hb Mv Bci Out Of State | $649 |
Inpatient
$734cash price (self-pay)
$734list price
$477–$628range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $477 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $477 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $477 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $477 |
| Commercial [1028] | Hb Mv Slhp Select Health | $477 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $477 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $477 |
| Mountain Health Co-Op [1067] | Hb Mv Slhp Mountain Health Coop | $477 |
| Pacificsource [1020] | Hb Mv Pacificsource Navigator Large Group | $477 |
| Pacificsource [1020] | Hb Mv Slhp Pacificsource Navigator Qhp | $477 |
| Select Health [1063] | Hb Mv Slhp Select Health | $477 |
| Select Health [1063] | Hb Mv Slhp Select Health Qhp | $477 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Large Gr | $477 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Qhp | $477 |
| Commercial [1028] | Hb Mv Va Ccn | $587 |
| Veterans Affairs [1056] | Hb Mv Va Ccn | $587 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $628 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $628 |
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