IV push, single drug at Intermountain Health American Fork Hospital. CPT 96374.
What Intermountain Health American Fork Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$263cash price (self-pay)
$350list price
$35.24–$315range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Adv HMO | $35.24 |
| Aetna | Medicare Adv PPO | $35.24 |
| American Health | Medicare Adv UT HMO I-SNP | $35.24 |
| Health Partners of Nevada | Medicare Advantage | $35.24 |
| Health Plan of Nevada | Medicaid | $35.24 |
| Healthy U | Medicaid | $35.24 |
| Humana | Medicare Choice PPO | $35.24 |
| Molina | Medicare Advantage | $35.24 |
| Molina | Medicare Choice Care HMO | $35.24 |
| Molina | Medicare Complete Care HMO SNP | $35.24 |
| Regence BCBS | MedAdvantage PPO | $35.24 |
| SelectHealth | Medicaid | $35.24 |
| SelectHealth | Medicare Advantage | $35.24 |
| UHC | Medicare Advantage | $35.24 |
| SelectHealth | Signature Individual ACA | $63.86 |
| SelectHealth | Value Individual ACA | $63.86 |
| SelectHealth | Med Individual ACA | $69.82 |
| Donor Connect | Other | $84.78 |
| Intermountain Caregiver Plan | Share Network | $105 |
| SelectHealth | FEHBP | $105 |
| SelectHealth | SelectShare | $105 |
| SelectHealth | SelectValue | $105 |
| Intermountain Caregiver Plan | Med Network | $115 |
| SelectHealth | CHP | $115 |
| SelectHealth | CH{ | $115 |
| SelectHealth | Commercial | $115 |
| SelectHealth | SelectCare | $119 |
| Deseret Mutual | All Other | $201 |
| Deseret Mutual | Select | $201 |
| Cigna | Open Access Flex | $221 |
Inpatient
$263cash price (self-pay)
$350list price
$6.31–$315range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $6.31 |
| Intermountain Caregiver Plan | Share Network | $149 |
| SelectHealth | FEHBP | $149 |
| Intermountain Caregiver Plan | Med Network | $169 |
| SelectHealth | CHP | $169 |
| SelectHealth | CH{ | $169 |
| SelectHealth | Commercial | $169 |
| EMI | Commercial | $189 |
| Deseret Mutual | All Other | $201 |
| Deseret Mutual | Select | $201 |
| Regence BCBS | BlueOption | $216 |
| Cigna | Open Access Flex | $221 |
| AWH Connected | Connected Utah | $222 |
| EMI Health | Mint | $243 |
| EMI Health | Network Care | $243 |
| PEHP | Advantage State | $244 |
| BYU Risk Management | Workers Comp | $245 |
| Corporation of the President | Workers Comp | $245 |
| Regence BCBS | High Performance | $245 |
| Regence BCBS | FEHBP | $247 |
| PEHP | Advantage Non-State | $249 |
| AG Administrators | USU Athletics | $252 |
| BYU Athletics | Commercial | $252 |
| Campbell Scientific | Commercial | $252 |
| CorVel Corporation | Workers Comp | $252 |
| Franklin County | Commercial | $252 |
| Juniper Systems | Commercial | $252 |
| LW Miller | Commercial | $252 |
| Injury Care of Nevada | Workers Comp | $263 |
| Regence BCBS | Traditional | $266 |
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All common services at Intermountain Health American Fork Hospital