IV push, single drug at Gundersen TriCounty Hospital and Clinics. CPT 96374.
What Gundersen TriCounty Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$233cash price (self-pay)
$367list price
$22.55–$349range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $22.55 |
| Anthem | Medicaid | $111 |
| Group Health Eau Claire | Medicaid HMO | $111 |
| Group Health of South Central | Medicaid HMO | $111 |
| Iowa Total Care | Medicaid | $111 |
| Managed Health Service | Managed Medicaid | $111 |
| Quartz | Medicaid_Badgercare | $111 |
| Quartz | All Products | $155 |
| Quartz | All Other Self Funded | $161 |
| Quartz | Self Funded | $172 |
| Quartz | Level Funded | $178 |
| UCARE | Non-Dually Eligible | $191 |
| UCARE | MSHO/Minnesota Special Needs | $191 |
| UCARE | Dually Eligible | $191 |
| Quartz | Fully Insured | $200 |
| Anthem | Medicare HMO/PPO | $217 |
| Humana | Medicare Advantage | $217 |
| Quartz | Medicare Advantage | $217 |
| UHC | Medicare Advantage | $217 |
| Anthem | State Specific | $253 |
| Anthem | PPO | $253 |
| Anthem | HMO/POS | $253 |
| UHC | All Payer Appendix | $264 |
| Cigna | All Products | $283 |
| Alliance | Premier/All Products | $287 |
| Alliance | Comprehensive/All Products | $288 |
| Group Health of South Central | All Products | $294 |
| Trilogy | All Products | $294 |
| UCARE | Qualified Health Plan | $294 |
| Aspirus Arise Health | All Products | $305 |
Inpatient
$233cash price (self-pay)
$367list price
$155–$349range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $216 |
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All common services at Gundersen TriCounty Hospital and Clinics