IV push, single drug at Bellin Memorial Hospital. CPT 96374.
What Bellin Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$162cash price (self-pay)
$588list price
$21.60–$1,060range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Managed Medicaid | $21.60 |
| COMMUNITY CARE | Managed Medicaid | $21.60 |
| ICARE | Managed Medicaid | $21.60 |
| Managed Health Service | Managed Medicaid | $21.60 |
| My Choice | SSI Managed Medicaid | $21.60 |
| Chorus Community Health Plan | Managed Medicaid | $22.00 |
| Molina Health | Managed Medicaid | $22.25 |
| My Choice | BadgerChoice Plus Managed Medicaid | $22.68 |
| Trilogy | Managed Medicaid | $22.68 |
| Healthpartners | Select | $106 |
| AETNA | Medicare | $207 |
| ANTHEM | Managed Medicare | $207 |
| COMMUNITY CARE | Medicare Advantage | $207 |
| HUMANA | Medicare Advantage | $207 |
| ICARE | Managed Medicare | $207 |
| Managed Health Service | Medicare Advantage | $207 |
| My Choice | Medicare Advantage | $207 |
| Network Health | Medicare Advantage | $207 |
| Security Health Plan | Medicare Advantage | $207 |
| Healthpartners | Focus | $211 |
| Healthpartners | Broad | $228 |
| Chorus Community Health Plan | ALL PRODUCTS | $378 |
| Aspirus Arise | ALL PRODUCTS | $394 |
| Cigna Health and Life Insurance Company | ALL PRODUCTS | $410 |
| HPS/Paymedix | Medical Rental Network Tier 1 | $423 |
| Security Health Plan | All Products | $447 |
| HPS/PayMedix | Medical Rental Network Tier 2 | $458 |
| Evernorth | Behavioral Health | $470 |
| HEALTHSMART | Medical Rental Network | $470 |
| IHS(ClaimsBridge) | Medical Rental Network | $470 |
Inpatient
$162cash price (self-pay)
$588list price
$225–$743range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna Health and Life Insurance Company | ALL PRODUCTS | $415 |
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