IV push, single drug at SSM Health St. Agnes Hospital - Fond du Lac. CPT 96374.
What SSM Health St. Agnes Hospital - Fond du Lac publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$186cash price (self-pay)
$363list price
$158–$406range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MOLINA | Medicare Managed Care Plan | $158 |
| BCBS | Anthem Medicare Managed Care Plan | $210 |
| Wellcare | Medicare Managed Care Plan | $215 |
| DOC | Government | $406 |
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All common services at SSM Health St. Agnes Hospital - Fond du Lac