IV push, single drug at Saint Alphonsus Medical Center-Ontario. CPT 96374.
What Saint Alphonsus Medical Center-Ontario publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$371cash price (self-pay)
$571list price
$97.07–$802range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Or | Moda Ods Eocco | $154 |
| Rx Medicaid | Medicaid | $171 |
| Medicaid - Nc | Medicaid | $171 |
| Rx Meridian Rx | Medicaid | $171 |
| Maryland Healthy Smiles - Scion Dental | Medicaid | $171 |
| Medicaid - Nj | Medicaid | $171 |
| Community Care Behavorial Health | Medicaid | $171 |
| Massachusetts Behavioral Health Partnership | Medicaid | $171 |
| Ucare Medicaid | Medicaid | $171 |
| Id County Payette | Medicaid County | $171 |
| Blue Cross - NY (Excellus) Medicaid Advantage | Medicaid | $171 |
| Chhuny | Medicaid | $171 |
| Centurion Of Idaho | Medicaid County | $171 |
| Keystone First Chc Medicaid | Medicaid | $171 |
| Carelon Health Medicaid | Medicaid | $171 |
| Medicaid - NY | Medicaid | $171 |
| Rx Medi-Cal | Medicaid | $171 |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | Medicaid | $171 |
| Health Safety Net | Medicaid | $171 |
| Medicaid - Nd | Medicaid | $171 |
| Rx 340b Pass Along | Medicaid | $171 |
| Selecthealth | Selecthealth Saha Network Small Grp | $237 |
| Pacificsource Health Plans Medicare Advantage | Pacificsource Medicare | $266 |
| Mountain Health Co-Op | Mountain Health Cooperative | $343 |
| Columbia Health Network | Columbia Health First Choice Network | $457 |
| Healthnet | Health Net | $480 |
| International Benefit Administrators | Multiplan | $514 |
| Asrm - Reliance Standard Life Insurance | Multiplan | $514 |
| Rural Carrier Health Benefit Plan | Aetna | $541 |
| Healthez | Aetna | $541 |
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All common services at Saint Alphonsus Medical Center-Ontario