Ondansetron injection at Intermountain Health Lutheran Hospital. CPT J2405.
What Intermountain Health Lutheran Hospital publishes for this service, straight from its standard-charges file, last updated March 22, 2026.
Outpatient / ER
—cash price (self-pay)
$12.46list price
$0.20–$104range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser Perm HMO | Kp Select HMO | $2.30 |
| Kaiser Perm HMO | Kaiser HMO Exchange Plan | $2.87 |
| Kaiser Perm HMO | Kaiser Out Of State | $2.87 |
| Kaiser Perm HMO | Kaiser Permanente HMO | $2.87 |
| Cigna | Cigna Co Public Option | $2.95 |
| Cigna | Cigna Connect Exchange | $2.95 |
| Cigna | Cigna Surefit | $2.95 |
| Allegiance | Cigna Sclhs Employees | $3.11 |
| Cigna Scl Employees | Cigna Sclhs Cdhp | $3.11 |
| BCBS/Anthem | BCBS Co Exchange Plan | $4.62 |
| BCBS/Anthem | BCBS Co Federal | $4.62 |
| BCBS/Anthem | BCBS Co HMO | $4.62 |
| BCBS/Anthem | BCBS Co PPO | $4.62 |
| Aetna | Aetna HMO/EPO | $4.63 |
| Aetna | Aetna Indemnity | $4.63 |
| Aetna | Aetna Other | $4.63 |
| Aetna | Aetna POS/Qpos | $4.63 |
| Aetna | Aetna PPO | $4.63 |
| Aetna | Aetna Src | $4.63 |
| Aetna | Christian Brothers Emp Ben Trst | $4.63 |
| Geha | Geha-Asa | $4.63 |
| Preferred One | Preferred One | $4.63 |
| Aetna | Aetna Colorado Preferred | $4.63 |
| Choicecare Humana | Choicecare Humana HMO EPO | $5.23 |
| Choicecare Humana | Choicecare Humana PPO | $5.23 |
| Cigna | Cigna HMO | $6.65 |
| Cigna | Cigna Indemnity | $6.65 |
| Cigna | Cigna Local Plus | $6.65 |
| Cigna | Cigna Other | $6.65 |
| Cigna | Cigna POS/Qpos | $6.65 |
Inpatient
—cash price (self-pay)
$12.46list price
$2.01–$116range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser Perm HMO | Kp Select HMO | $3.67 |
| Kaiser Perm HMO | Kaiser HMO Exchange Plan | $5.24 |
| Kaiser Perm HMO | Kaiser Out Of State | $5.24 |
| Kaiser Perm HMO | Kaiser Permanente HMO | $5.24 |
| Kaiser Self Funded | Kaiser Self Funded | $5.24 |
| Kaiser Perm PPO/POS | Kaiser Perm PPO/POS | $5.40 |
| Private Hlthcare Sys | Phcs Other | $9.35 |
| Private Hlthcare Sys | Phcs PPO | $9.35 |
| BCBS/Anthem | BCBS Co Indemnity | $10.46 |
| Multiplan Inc | Multiplan Inc Other | $10.46 |
| Multiplan Inc | Multiplan Inc PPO | $10.46 |
| Aetna | Aetna Nap | $11.17 |
| Cigna | Cigna HMO | $12.46 |
| Cigna | Cigna Indemnity | $12.46 |
| Cigna | Cigna Local Plus | $12.46 |
| Cigna | Cigna Other | $12.46 |
| Cigna | Cigna POS/Qpos | $12.46 |
| Cigna | Cigna PPO | $12.46 |
| Cigna | Eighth Dist Elect Ben Pln | $12.46 |
| Cigna | Health-Partners | $12.46 |
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All common services at Intermountain Health Lutheran Hospital