IV push, single drug at Medicine Lodge Memorial Hospital. CPT 96374.
What Medicine Lodge Memorial Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$75.00cash price (self-pay)
$361list price
$69.38–$361range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tricare West-All Plans | Tricare West-All Plans | $241 |
| BCBS Blue Choice | BCBS Blue Choice | $243 |
| BCBS Cap - All Other Plans | BCBS Cap - All Other Plans | $255 |
| Humana Mcr Adv-All Plans | Humana Mcr Adv-All Plans | $274 |
| Aetna Mcr Adv | Aetna Mcr Adv | $274 |
| Aetna Comm-All Other Plans | Aetna Comm-All Other Plans | $309 |
| Aetna/First Health Network | Aetna/First Health Network | $317 |
| Hpk-All Plans | Hpk-All Plans | $317 |
| Sunflower Mcaid-All Plans | Sunflower Mcaid-All Plans | $334 |
| Aetna Better Health Mcaid Chip | Aetna Better Health Mcaid Chip | $334 |
| UHC-All Plans | UHC-All Plans | $343 |
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