IV push, single drug at Intermountain Health Primary Children's Hospital. CPT 96374.
What Intermountain Health Primary Children's Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$236cash price (self-pay)
$315list price
$35.24–$277range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| American Health | Medicare Adv UT HMO I-SNP | $35.24 |
| Health Plan of Nevada | Medicaid | $35.24 |
| Healthy U | Medicaid | $35.24 |
| Molina | Medicaid | $35.24 |
| Molina | Medicare Advantage | $35.24 |
| Molina | Medicare Choice Care HMO | $35.24 |
| Molina | Medicare Complete Care HMO SNP | $35.24 |
| Southwest Behavioral Health | Behavioral Health | $35.24 |
| UHC | Medicare Advantage | $35.24 |
| SelectHealth | Medicaid | $79.73 |
| Donor Connect | Other | $125 |
| Aetna | Standard | $265 |
| BYU Athletics | Commercial | $265 |
| Campbell Scientific | Commercial | $265 |
| Cigna | HMO | $265 |
| Cigna | Open Access Flex | $265 |
| Cigna | PPO/EPO | $265 |
| Cigna | Utah Connect/Local Plus | $265 |
| Deseret Mutual | All Other | $265 |
| EMI Health | Mint | $265 |
| EMI Health | Network Care | $265 |
| EMI | Commercial | $265 |
| First Choice of the Midwest | Commercial | $265 |
| First Choice | Commercial | $265 |
| Franklin County | Commercial | $265 |
| Global Excel | Commercial | $265 |
| Health Utah | Commercial | $265 |
| Humana | Commercial | $265 |
| Hygeia Corporation | Commercial | $265 |
| Juniper Systems | Commercial | $265 |
Inpatient
$236cash price (self-pay)
$315list price
$114–$277range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $114 |
| American Health | Medicare Adv UT HMO I-SNP | $180 |
| Molina | Medicare Advantage | $189 |
| Molina | Medicare Choice Care HMO | $189 |
| Molina | Medicare Complete Care HMO SNP | $189 |
| AWH Connected | Connected Utah | $224 |
| Aetna | Connected | $224 |
| Aetna | Extended | $224 |
| Aetna | Standard | $224 |
| BYU Athletics | Commercial | $224 |
| Campbell Scientific | Commercial | $224 |
| Cigna | HMO | $224 |
| Cigna | Open Access Flex | $224 |
| Cigna | PPO/EPO | $224 |
| Cigna | Utah Connect/Local Plus | $224 |
| Deseret Mutual | All Other | $224 |
| EMI Health | Mint | $224 |
| EMI Health | Network Care | $224 |
| EMI | Commercial | $224 |
| First Choice of the Midwest | Commercial | $224 |
| First Choice | Commercial | $224 |
| Franklin County | Commercial | $224 |
| Global Excel | Commercial | $224 |
| Health Utah | Commercial | $224 |
| Humana | Commercial | $224 |
| Hygeia Corporation | Commercial | $224 |
| Juniper Systems | Commercial | $224 |
| LW Miller | Commercial | $224 |
| Managed Care Admin | Commercial | $224 |
| MedCare International | Commercial | $224 |
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All common services at Intermountain Health Primary Children's Hospital