IV push, single drug at Roxborough Memorial Hospital. CPT 96374.
What Roxborough Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$217cash price (self-pay)
$1,016list price
$31.02–$985range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Partners Plan | Health Partners Plan Medicaid | $31.02 |
| Keystone | Keystone First Medicaid | $32.90 |
| UHC | UHC Medicaid | $35.05 |
| Humana Military Tricare | Humana Military Tricare | $174 |
| Health Partners Plan | Health Partners Plan Medicare | $217 |
| Independence Blue Cross | IBC Medicare | $217 |
| PA Health & Wellness | PA Health & Wellness Medicare & Duals | $217 |
| Traditional Medicare | Traditional Medicare | $217 |
| Tricare | Tricare | $217 |
| UHC | UHC Medicare | $217 |
| UHC | UHC Va Ccn | $217 |
| Providers Partner Health Plan | Provider Partners Health Plan | $224 |
| Keystone | Keystone First Medicare | $226 |
| Ally-Align Medicare | Ally-Align Medicare | $228 |
| Spartan | Spartan Plan | $228 |
| Auto Insurance | Auto Insurance | $239 |
| Worker Compensation | Worker Compensation | $246 |
| PA Health & Wellness | PA Health & Wellness Commercial Insurance Excha | $261 |
| Employer Direct Healthcare | Employer Direct Healthcare | $304 |
| Health Partners Plan | Health Partners Plan Exchange | $326 |
| Naphcare | Naphcare | $337 |
| UHC | UHC Exchange | $342 |
| UHC | UHC Commercial All Payer | $455 |
| Highmark | Highmark Commercial (02-01-2024 to 12-31-2026) | $474 |
| Cigna | Cigna Commercial (05-01-2023 to 12-31-2026) | $514 |
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