IV push, single drug at Plaistow Emergency Room. CPT 96374.
What Plaistow Emergency Room publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$452cash price (self-pay)
$513list price
$13.95–$977range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AmeriHealth Caritas | MCD | $15.85 |
| Well Sense Health Plan | MCD | $38.42 |
| Harvard Pilgrim | INDIVIDUAL | $98.44 |
| United | FreedomBenefitPlans | $108 |
| Harvard Pilgrim | ELEVATE | $108 |
| Harvard Pilgrim | HMO | $123 |
| Harvard Pilgrim | POS | $123 |
| Maine Community Health | Individual | $160 |
| Maine Community Health | SmallGroup | $160 |
| Cigna | HMO | $187 |
| United | AllPayerAppendix | $215 |
| Cigna | PPO | $216 |
| Anthem | INDEMNITY | $224 |
| Harvard Pilgrim | PPO | $231 |
| Maine Community Health | LargeGroup | $272 |
| Tufts Health Plan | POS | $293 |
| Tufts Health Plan | HMO | $302 |
| Tufts Health Plan | PPO | $302 |
| Aetna | HMO | $305 |
| United | OptionsPPO | $311 |
| Aetna | EPO | $343 |
| Aetna | POS | $343 |
| Aetna | PPO | $343 |
| MVP Health Plan | COMM | $359 |
| CorVel | WorkersComp | $369 |
| EverNorth | COMM | $410 |
| Healthcare Value Mgmt | COMM | $431 |
| First Health | PPO | $436 |
| Oxford Health Plans | COMM | $487 |
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