IV push, single drug at Froedtert Holy Family Memorial Hospital. CPT 96374.
What Froedtert Holy Family Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$187cash price (self-pay)
$340list price
$112–$709range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medical College of Wisconsin | Employee Plan | $112 |
| Centivo | WI 2 Median | $136 |
| Centivo | WI 1 Broad | $156 |
| Dean Health Plan | All Plans | $170 |
| Health Payment Systems | All Contracted Commercial Plans | $192 |
| Anthem Blue Cross Blue Shield | Medicare Advantage | $200 |
| Community Care Incorporated | Medicare Advantage | $200 |
| Health Partners | Medicare Advantage | $200 |
| Humana | Medicare Advantage | $200 |
| ICare | Medicare Advantage | $200 |
| Molina | Medicare Advantage | $200 |
| Network Health Plan | Medicare Advantage | $200 |
| Security Health Plan | Medicare Advantage | $200 |
| United Healthcare | Medicare Advantage | $200 |
| Anthem Blue Cross Blue Shield (Healthlink) | HMO/PPO | $201 |
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $204 |
| Allwell | Medicare Advantage | $204 |
| Molina | Marketplace Plans | $216 |
| Chorus Community Health Plan | Marketplace Plans | $219 |
| Health Partners | All Contracted Commercial Plans | $221 |
| Trilogy | All Contracted Commercial Plans | $224 |
| Cigna | All Contracted Commercial Plans | $245 |
| WPS Health Plan | All Contracted Commercial Plans | $252 |
| Aspirus | Marketplace Plans | $272 |
| HealthEos | All Contracted Commercial Plans | $272 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $272 |
| Preferred One | All Contracted Commercial Plans | $272 |
| Security Health Plan | All Contracted Commercial Plans | $272 |
| HealthSmart | All Contracted Commercial Plans | $282 |
| First Health Network | All Contracted Commercial Plans | $299 |
Inpatient
$187cash price (self-pay)
$340list price
$204–$299range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $204 |
| Trilogy | All Contracted Commercial Plans | $224 |
| Cigna | All Contracted Commercial Plans | $245 |
| Aspirus | Marketplace Plans | $272 |
| HealthEos | All Contracted Commercial Plans | $272 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $272 |
| Preferred One | All Contracted Commercial Plans | $272 |
| Security Health Plan | All Contracted Commercial Plans | $272 |
| HealthSmart | All Contracted Commercial Plans | $282 |
| First Health Network | All Contracted Commercial Plans | $299 |
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All common services at Froedtert Holy Family Memorial Hospital