IV push, single drug at Essentia Health-Holy Trinity Hospital (Graceville). CPT 96374.
What Essentia Health-Holy Trinity Hospital (Graceville) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$205cash price (self-pay)
$278list price
$108–$252range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| HealthPartners CARE PMAP | Medicaid | $108 |
| Medica Access | Medicaid | $111 |
| Sanford HealthPlan | Commercial-NDPERS | $119 |
| Sanford HealthPlan | Commercial | $126 |
| BCBS Nd | BCBS Mn | $149 |
| HealthPartners | SHP | $169 |
| Advocare/Security Health | Medicare | $172 |
| BLUE CROSS MEDICARE ADVANTAGE CORE | Medicare | $172 |
| Freedom Blue PPO | Medicare | $172 |
| HEALTHPARTNERS CARE MSHO / MCR ADV | Medicare | $172 |
| IMCARE MSHO PCC PRIME | Medicare | $172 |
| IMCARE MSHO REF REQ | Medicare | $172 |
| MEDICA ADVANTAGE SOLUTIONS | Medicare | $172 |
| MEDICA MSHO/Dual Solutions | Medicare | $172 |
| MEDICA PRIME SOLUTION GROUP | Medicare | $172 |
| MEDICARE ADV PFFS | Medicare | $172 |
| ND VA ADMINISTRATION | Medicare | $172 |
| OUT OF STATE BCBS MEDICARE ADVANTAGE | Medicare | $172 |
| PRIMEWEST MSHO | Medicare | $172 |
| Platinum Blue/Vantage Blue | Medicare | $172 |
| SECURE BLUE MSHO | Medicare | $172 |
| SECURITY HEALTH MEDICARE | Medicare | $172 |
| UBH COST PLAN | Medicare | $172 |
| UBH MSHO/MEDICARE REPLACEMENT | Medicare | $172 |
| UBH MSHO | Medicare | $172 |
| Cigna | Commercial | $185 |
| HealthPartners PCC Prime | Commercial | $185 |
| HealthPartners | Commercial | $185 |
| Primewest | Medicaid | $207 |
| Itasca Med Care | Medicaid | $211 |
Inpatient
$205cash price (self-pay)
$278list price
$108–$252range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| HealthPartners CARE PMAP | Medicaid | $108 |
| Sanford HealthPlan | Commercial-NDPERS | $119 |
| Sanford HealthPlan | Commercial | $126 |
| BCBS MN | Medicaid | $153 |
| BLUE PLUS PMAP PCC PRIME | Medicaid | $153 |
| HealthPartners | SHP | $169 |
| Medica Access | Medicaid | $173 |
| Ucare | Commercial | $183 |
| Cigna | Commercial | $185 |
| HealthPartners PCC Prime | Commercial | $185 |
| HealthPartners | Commercial | $185 |
| MN BCBS Commercial | BCBS MN | $195 |
| WEA | Commercial-Narrow Network | $200 |
| WEA | Commercial | $214 |
| America's PPO | Commercial | $215 |
| WPS | Commercial | $231 |
| Medica Uplan | Commercial | $231 |
| Medica | Commercial-FI | $231 |
| Medica | Commercial-SI | $231 |
| Aetna First Health | Commercial | $236 |
| Medica | IFB ACO | $243 |
| Medica Choice | Commercial | $250 |
| UHC | Commercial | $252 |
| UMR | Commercial | $252 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Essentia Health-Holy Trinity Hospital (Graceville)