ProMedica Charles and Virginia Hickman Hospital — Infusion prices
← Hospital overviewVerified from ProMedica Charles and Virginia Hickman Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
6 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| IV inf hydrate 1st hr Inpatient | 96360 CPT | $417 | $271 | $167 – $334 | — | |
| IV inf hydrate 1st hr Outpatient | 96360 CPT | $417 | $271 | $145 – $417 | — | |
| IV inf txprodx 1st hr Inpatient | 96365 CPT | $707 | $460 | $283 – $566 | — | |
| IV inf txprodx 1st hr Outpatient | 96365 CPT | $707 | $460 | $279 – $707 | — | |
| IV inf txprodx add hr Inpatient | 96366 CPT | $213 | $138 | $85.20 – $170 | — | |
| IV inf txprodx add hr Outpatient | 96366 CPT | $213 | $138 | $85.20 – $213 | — |