IV push, single drug at St. Luke's Health - Lakeside Hospital. CPT 96374.
What St. Luke's Health - Lakeside Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$307cash price (self-pay)
$876list price
$57.87–$876range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS - TX | Commercial|MyBlue Health Exchange | $57.87 |
| BCBS-TX | Commercial|Exchange | $66.99 |
| BCBS-TX | Commercial|Blue Premier | $84.04 |
| Cigna | Commercial|HMO | $100 |
| Cigna | Commercial|PPO | $100 |
| Cigna | Commercial|Surefit | $100 |
| BCBS-TX | Commercial|HMO | $111 |
| United | Commercial|Exchange | $121 |
| BCBS-TX | Commercial|PPO | $126 |
| Renaissance | Commercial|All Plans | $152 |
| United | Commercial|Charter | $177 |
| United | Commercial|HMO | $196 |
| United | Commercial|PPO | $196 |
| AETNA | Medicare|All Plans | $215 |
| KelseyCare | Commercial|Exchange | $285 |
| TCHPCHIP | Medicaid|HMO | $307 |
| Ambetter | Commercial|All Plans | $317 |
| Community Health Choice | Commercial|All Other Plans | $317 |
| Community Health Choice | Commercial|Exchange | $317 |
| Harris Health | Commercial|ERS | $317 |
| Wellpoint | Commercial|Exchange | $317 |
| OPTUM | Medicaid|STAR | $317 |
| Aetna | Commercial|Exchange | $325 |
| Bright Health | Commercial|All Plans | $342 |
| United | Commercial|Optum | $412 |
| CHC | Medicaid|CHIP | $482 |
| CHC | Medicaid|HMO | $482 |
| TEXASTRUECHOICE | Medicaid|CHIP | $482 |
| Cigna Lifesource | Commercial|Transplant | $526 |
| Coventry | Commercial|PPO | $569 |
Inpatient
$307cash price (self-pay)
$876list price
$385–$876range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| TCHPCHIP | Medicaid|HMO | $385 |
| CHC | Medicaid|CHIP | $482 |
| CHC | Medicaid|HMO | $482 |
| TEXASTRUECHOICE | Medicaid|CHIP | $482 |
| Coventry | Commercial|PPO | $569 |
| First Health | Commercial|All Plans | $569 |
| Humana | Commercial|Transplant | $569 |
| Cigna | Commercial|Transplant | $613 |
| Healthsmart | Commercial|PPO | $613 |
| Interlink | Commercial|Transplant | $613 |
| MultiPlan | Commercial|All Plans | $657 |
| USA Health Network | Commercial|All Plans | $745 |
| MHealth Network | Commercial|PPO | $876 |
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All common services at St. Luke's Health - Lakeside Hospital