IV push, single drug at Jacksonville Memorial Hospital. CPT 96374.
What Jacksonville Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$595cash price (self-pay)
$603list price
$0.87–$982range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield | Blue Cross Community MMAI/Dual Eligible | $60.03 |
| Coventry | Coventry Advantra Medicare Advantage HMO | $64.27 |
| Health Alliance | Health Alliance Medicare Advantage | $64.27 |
| Humana | Humana/ChoiceCare Medicare Advantage PPO/HMO | $64.27 |
| Medicare | Medicare | $64.27 |
| United HealthCare | United HealthCare Medicare Advantage | $67.48 |
| Tricare | Tricare | $70.13 |
| Medicaid | Illinois Medicaid | $90.72 |
| Molina HealthCare | Molina Medicaid | $90.72 |
| WellCare Medicare Advantage PPO | WellCare Medicare Advantage PPO | $94.94 |
| UHC Va Ccn | UHC Va Ccn | $96.48 |
| Commercial Workers Compensation | Commercial Workers Compensation | $151 |
| Illinois Workers Compensation | Illinois Workers Compensation | $202 |
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $277 |
| Corvel/CorCare | Corvel/CorCare | $332 |
| 6 Degrees Health | 6 Degrees Health | $362 |
| Hope Trust | Hope Trust | $362 |
| Hst | Hst | $362 |
| Health Alliance | Health Alliance Fully Insured/Self Funded/ACA | $405 |
| Cigna | Cigna | $418 |
| United Healthcare | United Healthcare PPO | $440 |
| Aetna | Aetna PPO | $452 |
| Current Health Network | Current Health Network | $452 |
| Healthlink | Healthlink HMO | $506 |
| Humana/ChoiceCare | Humana/ChoiceCare | $514 |
| PHCS/Multiplan | PHCS/Multiplan PPO | $543 |
| Hfn | Hfn PPO | $573 |
| HFN | HFN Workers Compensation | $573 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $603 |
| Liability | Liability | $603 |
Inpatient
$595cash price (self-pay)
$603list price
$274–$611range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $277 |
| Current Health Network | Current Health Network | $332 |
| 6 Degrees Health | 6 Degrees Health | $362 |
| Hope Trust | Hope Trust | $362 |
| Hst | Hst | $362 |
| Cigna | Cigna | $418 |
| Aetna | Aetna PPO | $422 |
| Humana/ChoiceCare | Humana/ChoiceCare | $514 |
| Hfn | Hfn PPO | $573 |
| HFN | HFN Workers Compensation | $573 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $603 |
| Liability | Liability | $603 |
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