IV push, single drug at Henry Ford Jackson Hospital. CPT 96374.
What Henry Ford Jackson Hospital publishes for this service, straight from its standard-charges file, last updated June 28, 2026.
Outpatient / ER
$48.48cash price (self-pay)
$302list price
$24.07–$490range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Military | Tricare | $30.05 |
| HAP | Commercial | $54.44 |
| Blue Cross | BCBSM Commercial | $111 |
| Blue Cross | Blue Cross Complete | $114 |
| HAP | HAP Caresource Medicaid | $114 |
| McLaren | Medicaid HMO | $114 |
| Meridian | Medicaid HMO | $114 |
| Priority Health | Medicaid HMO | $114 |
| Aetna Better Health | Medicaid HMO | $119 |
| Molina | Medicaid HMO | $120 |
| McLaren | Commercial | $161 |
| Bcn | HMO | $163 |
| Blue Cross | BCN Commercial | $163 |
| Priority Health | Priority Cigna | $165 |
| Jackson County Sheriff | Jackson County Jail | $166 |
| Veterans Evaluation Services | All Products | $189 |
| Immergrun Inc | ALL PRODUCTS | $192 |
| Nomi | All Products | $208 |
| Aetna | Commercial | $212 |
| Aetna | Medicare Advantage | $213 |
| Blue Cross | BCN Advantage | $213 |
| Blue Cross | Medicare Plus Blue | $213 |
| Cascade Thome Pace | All Products | $213 |
| Humana | Medicare Advantage | $213 |
| McLaren | Medicare Advantage | $213 |
| Molina | Dual MI Coordinated Health | $213 |
| Priority Health | Medicare Advantage | $213 |
| Priority Health | Dual Premier_HIDE-SNP | $213 |
| United Healthcare | VACCN | $213 |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP) | $213 |
Inpatient
—cash price (self-pay)
$320list price
$161–$288range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | UHC Commercial | $236 |
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