IV push, single drug at Henry Ford Wyandotte Hospital:. CPT 96374.
What Henry Ford Wyandotte Hospital: publishes for this service, straight from its standard-charges file, last updated June 28, 2026.
Outpatient / ER
$51.21cash price (self-pay)
$283list price
$24.07–$487range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| ScriptGuideRX | All Products | $25.23 |
| Humana Military | Tricare | $31.34 |
| Blue Cross | GM Connected Care | $50.33 |
| Blue Cross | BCBSM Commercial | $88.84 |
| HAP | HAP Caresource Medicaid | $114 |
| McLaren | Medicaid HMO | $114 |
| Meridian | Medicaid HMO | $114 |
| Priority Health | Medicaid HMO | $114 |
| Aetna Better Health | Medicaid HMO | $116 |
| Bcn | HMO | $119 |
| Blue Cross | BCN Commercial | $119 |
| Molina | Medicaid HMO | $120 |
| Priority Health | Priority Cigna | $125 |
| HAP | HAP HMO_AHL_Fully Insured | $134 |
| Cofinity | Commercial | $141 |
| HAP | Self-Funded | $143 |
| Blue Cross | BCBSM GM Connected Care | $149 |
| United Healthcare | UHC Commercial | $183 |
| United Healthcare | Baseline Benefit Plan | $183 |
| Aetna | Commercial | $189 |
| Multiplan | All Products | $201 |
| Pace SE MI | Medicare Advantage | $201 |
| Amerihealth Caritas | Dual Products | $208 |
| Aetna | Medicare Advantage | $212 |
| Blue Cross | BCN Advantage | $212 |
| Blue Cross | Medicare Plus Blue | $212 |
| HAP | HAP Dual Products | $212 |
| HAP | Medicare Advantage | $212 |
| McLaren | Medicare Advantage | $212 |
| Molina | Dual MI Coordinated Health | $212 |
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