Ondansetron injection at St. Luke's Jerome Standard Charges. CPT J2405.
What St. Luke's Jerome Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$0.99cash price (self-pay)
$4.94list price
$0.11–$14.30range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna [1062] | Hb Mv Cigna | $0.43 |
| Commercial [1028] | Hb Mv Cigna | $0.43 |
| Providence [1022] | Hb Mv Cigna | $0.43 |
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $0.60 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $0.60 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $0.60 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $0.60 |
| Commercial [1028] | Hb Mv Slhp Select Health | $0.60 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $0.60 |
| Mountain Health Co-Op [1067] | Hb Mv Slhp Mountain Health Coop | $0.60 |
| Pacificsource [1020] | Hb Mv Pacificsource Navigator Large Group | $0.60 |
| Pacificsource [1020] | Hb Mv Slhp Pacificsource Navigator Qhp | $0.60 |
| Select Health [1063] | Hb Mv Slhp Select Health | $0.60 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $3.21 |
| Commercial [1028] | Hb Mv H2b | $3.71 |
| H2b [1068] | Hb Mv H2b | $3.71 |
| Pacificsource [1020] | Hb Mv Pacificsource PPO Voyager | $3.71 |
| Commercial [1028] | Hb Mv Va Ccn | $3.95 |
| Veterans Affairs [1056] | Hb Mv Va Ccn | $3.95 |
| Aetna [1021] | Hb Mv Bp Aetna | $3.95 |
| Commercial [1028] | Hb Mv Bp Aetna | $3.95 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $3.95 |
| Webtpa [1071] | Hb Mv Bp Aetna | $3.95 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $4.13 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $4.13 |
| Commercial [1028] | Hb Mv Amps | $4.20 |
| Commercial [1028] | Hb Mv Christian Health Aid | $4.20 |
| Commercial [1028] | Hb Mv First Choice Health | $4.20 |
| First Health [1064] | Hb Mv First Choice Health | $4.20 |
| Webtpa [1071] | Hb Mv First Choice Health | $4.20 |
Inpatient
$0.99cash price (self-pay)
$4.94list price
$0.79–$12.04range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $3.21 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $3.21 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $3.21 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $3.21 |
| Commercial [1028] | Hb Mv Slhp Select Health | $3.21 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $3.21 |
| Mountain Health Co-Op [1067] | Hb Mv Slhp Mountain Health Coop | $3.21 |
| Pacificsource [1020] | Hb Mv Pacificsource Navigator Large Group | $3.21 |
| Pacificsource [1020] | Hb Mv Slhp Pacificsource Navigator Qhp | $3.21 |
| Select Health [1063] | Hb Mv Slhp Select Health | $3.21 |
| Select Health [1063] | Hb Mv Slhp Select Health Qhp | $3.21 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Large Gr | $3.21 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Qhp | $3.21 |
| Cigna [1062] | Hb Mv Cigna | $3.95 |
| Commercial [1028] | Hb Mv Cigna | $3.95 |
| Providence [1022] | Hb Mv Cigna | $3.95 |
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