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
Inj Tx/Dx/Proph; Ea Add IV Push New Subst
LAFAYETTE, IN
See all hospitals reporting CPT 96375 →Price type
FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE’s median price of $142 is 68% above the median hospital's median price ($85), higher than 72% 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: 9 payers, 16 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.
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| # | ||||
|---|---|---|---|---|
| 1 | Medicare medicare-wir-lafayette other · both | $49.54 | $49.54 | $49.54 – $49.54 |
| 2 | Medicaid in mcd-wir-lafayette per diem · both | $73.71 | $73.71 | $73.71 – $73.71 |
| 3 | Medicaid in mcd lafayet caresource 120% of in mcd per diem · both | $88.45 | $88.45 | $88.45 – $88.45 |
| 4 | Aetna aetna-nid-dyer-munster-crn point percent of total billed charges · bothfrom % of charges | $109.47 | $109.47 | $109.47 – $109.47 |
| 5 | UnitedHealthcare united healthcare charter-wid-lafayette percent of total billed charges · bothfrom % of charges | $116.15 | $116.15 | $116.15 – $116.15 |
| 6 | Blue Cross Blue Shield anthem franciscan employee copps- all locations other · both | $119.79 | $119.79 | $119.79 – $119.79 |
| 7 | UnitedHealthcare uhc all payer-wid-lafayette percent of total billed charges · bothfrom % of charges | $128.96 | $128.96 | $128.96 – $128.96 |
| 8 | UnitedHealthcare united healthcare options ppo-wid-lafaye percent of total billed charges · bothfrom % of charges | $142.04 | $142.04 | $142.04 – $142.04 |
| 9 | Blue Cross Blue Shield anthem healthsync hmo with copps - lafayette other · both | $144.85 | $144.85 | $144.85 – $144.85 |
| 10 | Blue Cross Blue Shield anthem healthsync pos with copps - lafayette other · both | $164.11 | $164.11 | $164.11 – $164.11 |
| 11 | Humana choice care-wir percent of total billed charges · bothfrom % of charges | $180.14 | $180.14 | $180.14 – $180.14 |
| 12 | Bcbs Il anthem blue access ppo with copps - lafayette other · both | $183.36 | $183.36 | $183.36 – $183.36 |
| 13 | Bcbs In anthem blue access ppo with copps - lafayette other · both | $183.36 | $183.36 | $183.36 – $183.36 |
| 14 | Blue Cross Blue Shield anthem blue access ppo with copps - lafayette other · both | $183.36 | $183.36 | $183.36 – $183.36 |
| 15 | Aetna aetna-wid percent of total billed charges · bothfrom % of charges | $189.04 | $189.04 | $189.04 – $189.04 |
| 16 | Cigna cigna behavioral health-wid-lafayette percent of total billed charges · bothfrom % of charges | $213.60 | $213.60 | $213.60 – $213.60 |
Last updated: Jan 1, 2026
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