Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HCHG IV INJECTION TX/DX/PROPHYLAXIS ADDL SEQUENTIA
Minneapolis, MN
See all hospitals reporting CPT 96375 →Price type
Allina Health Systems’s median price of $108 is 28% above the median hospital's median price ($85), higher than 59% of the 2,521 hospitals reporting CPT 96375. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 31 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $44.44 | $44.44 | $44.44 – $44.44 |
| 2 | Medicaid medicaid ma (a) facility · fee schedule · outpatient | $44.61 | $44.61 | $44.61 – $44.61 |
| 3 | Aetna allina aetna medicare (a) facility · fee schedule · outpatient | $45.85 | $45.85 | $45.85 – $45.85 |
| 4 | Medicare medicare (a) facility · fee schedule · outpatient | $48.26 | $48.26 | $48.26 – $48.26 |
| 5 | Blue Cross Blue Shield bc medicare (a) facility · fee schedule · outpatient | $50.67 | $50.67 | $50.67 – $50.67 |
| 6 | Medica medica medicare (a) facility · fee schedule · outpatient | $50.67 | $50.67 | $50.67 – $50.67 |
| 7 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $55.53 | $54.12 | $49.45 – $57.38 |
| 8 | UnitedHealthcare uhc ubh pmap (a) facility · other · outpatient | $55.76 | $55.76 | $55.76 – $55.76 |
| 9 | Medica medica pmap (a) facility · percent of total billed charges · outpatientfrom % of charges | $61.27 | $59.72 | $54.57 – $63.31 |
| 10 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $97.29 | $94.82 | $86.64 – $100.53 |
| 11 | Bcbs Mn bc state health plan (a) facility · other · outpatient | $100.05 | $100.05 | $100.05 – $100.05 |
| 12 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $103.50 | $100.88 | $92.18 – $106.95 |
| 13 | Bcbs Mn bc premier (a) facility · other · outpatient | $106.20 | $106.20 | $106.20 – $106.20 |
| 14 | Cigna hpi cigna (a) facility · other · outpatient | $115.50 | $115.50 | $115.50 – $115.50 |
| 15 | Medica medica dual solutions (a u) facility · percent of total billed charges · outpatientfrom % of charges | $122.54 | $119.44 | $109.14 – $126.63 |
| 16 | Blue Cross Blue Shield bc aehp (a) facility · other · outpatient | $124.92 | $124.92 | $124.92 – $124.92 |
| 17 | Bcbs Mn bc high value/performance network (a) facility · other · outpatient | $134.10 | $134.10 | $134.10 – $134.10 |
| 18 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $150.81 | $146.98 | $134.31 – $155.83 |
| 19 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $163.14 | $158.28 | $144.28 – $167.41 |
| 20 | UnitedHealthcare united healthcare (a) facility · percent of total billed charges · outpatientfrom % of charges | $166.98 | $166.98 | $166.98 – $166.98 |
| 21 | Medica medica ubh (a) facility · percent of total billed charges · inpatientfrom % of charges | $193.20 | $188.30 | $172.06 – $199.64 |
| 22 | Medica medica elect (a) facility · percent of total billed charges · outpatientfrom % of charges | $204.96 | $199.76 | $182.53 – $211.79 |
| 23 | Medica medica essentials (a) facility · percent of total billed charges · outpatientfrom % of charges | $213.62 | $208.20 | $190.25 – $220.74 |
| 24 | Medica medica mhps (a) facility · percent of total billed charges · outpatientfrom % of charges | $213.98 | $208.56 | $190.57 – $221.12 |
| 25 | Medica medica ubh pmap (a) facility · percent of total billed charges · outpatientfrom % of charges | $220.80 | $215.20 | $196.64 – $228.16 |
Last updated: Jun 16, 2026
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