IV push, single drug at Good Samaritan Hospital. CPT 96374.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated June 29, 2026.
Outpatient / ER
$1,173cash price (self-pay)
$1,173list price
$147–$11,494range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Beacon Commercial | Beacon Commercial | $193 |
| Beacon Medicare | Beacon Medicare | $264 |
| Hamaspik (Mcr) | Hamaspik (Mcr) | $264 |
| Medicare Managed | Medicare Managed | $264 |
| Mvp Gold (Mcr) | Mvp Gold (Mcr) | $264 |
| World Trade Center Fdny | World Trade Center Fdny | $264 |
| World Trade Center Other | World Trade Center Other | $264 |
| Tricare | Tricare | $266 |
| Medicare | Medicare | $266 |
| Emblem Ghi/Hip Medicare | Emblem Ghi/Hip Medicare | $269 |
| Affinity By Molina Mcr | Affinity By Molina Mcr | $277 |
| Health First Medicare | Health First Medicare | $283 |
| Beacon Exchange | Beacon Exchange | $317 |
| SELF-PAY - CC 30% | SELF-PAY - CC 30 PerCent | $352 |
| Blue Cross Small Group | Blue Cross Small Group | $528 |
| Blue Cross HMO | Blue Cross HMO | $587 |
| Self-Pay - Cc 50% | Self-Pay - Cc 50 | $587 |
| Emblem Select Care (Exchange) | Emblem Select Care (Exchange) | $798 |
| Cigna PPO | Cigna PPO | $821 |
| Magnacare Standard | Magnacare Standard | $821 |
| Geisinger Health Commercial/Exchange | Geisinger Health Commercial/Exc | $872 |
| Multiplan | Multiplan | $880 |
| Phcs | Phcs | $880 |
| Emblem Ghi/Hip HMO/EPO/POS | Emblem Ghi/Hip HMO/EPO/POS | $938 |
| Emblem Ghi/Hip PPO | Emblem Ghi/Hip PPO | $938 |
| First Health | First Health | $997 |
| Blue Cross Connection/Exchange | Blue Cross Connection/Exchange | $1,230 |
| Blue Cross Access | Blue Cross Access | $1,307 |
| Oxford Exchange | Oxford Exchange | $1,530 |
| UHC Exchange | UHC Exchange | $1,530 |
Inpatient
$1,173cash price (self-pay)
$1,173list price
$352–$821range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SELF-PAY - CC 30% | SELF-PAY - CC 30 PerCent | $352 |
| Cdphp | Cdphp | $587 |
| Self-Pay - Cc 50% | Self-Pay - Cc 50 | $587 |
| Magnacare Standard | Magnacare Standard | $821 |
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