IV fluids, first hour at Good Samaritan Hospital (GSH). CPT 96360.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$290cash price (self-pay)
$484list price
$28.02–$484range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicaid | $28.02 |
| Caresource HIP | Medicaid | $28.02 |
| Caresource | Medicaid | $28.02 |
| Encore Prime | Commercial | $36.54 |
| Aetna | Commercial | $63.66 |
| Aetna | Medicare Advantage | $128 |
| Allwell | MCR ADV/PPO/HMO | $128 |
| Anthem MCR | MCR ADV/PPO/HMO | $128 |
| Anthem MCR | Medicare Advantage | $128 |
| Anthem | MCR ADV/PPO/HMO | $128 |
| Cigna | Medicare Advantage | $128 |
| Humana | Medicare Advantage | $128 |
| United Healthcare | Medicare Advantage | $128 |
| Alliance Coal | Commercial | $184 |
| CareSource | Commercial | $188 |
| Direct Health | Direct Health | $201 |
| Anthem | Trad/PPO/HMO | $206 |
| OneCare | Commercial | $208 |
| Indiana University | MCR ADV/PPO/HMO | $225 |
| MHS Ambetter | Commercial | $225 |
| Meridian | Medicare Advantage | $225 |
| Molina | Medicaid | $225 |
| Molina | Medicare Advantage | $225 |
| Optum | MCR ADV/PPO/HMO | $225 |
| Amish | Commercial | $242 |
| HealthLink | HMO | $252 |
| Hope Trust | Commercial | $256 |
| HealthLink | PPO | $264 |
| Anthem | Exchange | $276 |
| United Healthcare | Commercial | $318 |
Inpatient
$290cash price (self-pay)
$484list price
$282–$484range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $282 |
| United Healthcare | Commercial | $320 |
| Anthem | Trad/PPO/HMO | $352 |
| Direct Health | Direct Health | $371 |
| SIHO | Commercial | $371 |
| Cigna | Commercial | $382 |
| Sagamore | Commercial | $382 |
| Corvel | Workers Comp | $397 |
| Aetna | Commercial | $406 |
| Anthem | HealthSync | $416 |
| HealthLink | HMO | $426 |
| Encore Prime | Commercial | $436 |
| Humana | Commercial | $436 |
| HealthLink | PPO | $450 |
| Molina | Medicaid | $484 |
| Underwriters Safety | Commercial | $484 |
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