Ondansetron injection at Good Samaritan Hospital (GSH). CPT J2405.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$22.20cash price (self-pay)
$37.00list price
$0.06–$65.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicaid | $0.06 |
| Caresource HIP | Medicaid | $0.06 |
| Caresource | Medicaid | $0.06 |
| Aetna | Medicare Advantage | $0.09 |
| Alliance Coal | Commercial | $0.09 |
| Anthem HIP | HIP | $0.09 |
| Anthem MCR | MCR ADV/PPO/HMO | $0.09 |
| Anthem MCR | Medicare Advantage | $0.09 |
| Anthem | MCR ADV/PPO/HMO | $0.09 |
| BCBS | Medicare Advantage | $0.09 |
| Cigna | Medicare Advantage | $0.09 |
| Humana | Medicare Advantage | $0.09 |
| United Healthcare | Medicare Advantage | $0.09 |
| Allwell | MCR ADV/PPO/HMO | $0.09 |
| CareSource | Commercial | $0.11 |
| Hope Trust | Commercial | $0.18 |
| Amish | Commercial | $18.50 |
| Anthem | Exchange | $21.11 |
| United Healthcare | Commercial | $24.27 |
| Aetna | Commercial | $24.83 |
| Anthem | Trad/PPO/HMO | $26.39 |
| OneCare | Commercial | $28.19 |
| Indiana University | Commercial | $28.19 |
| Direct Health | Direct Health | $28.38 |
| SIHO | Commercial | $28.38 |
| Cigna | Commercial | $29.23 |
| Sagamore | Commercial | $29.23 |
| Corvel | Workers Comp | $30.34 |
| Anthem | HealthSync | $31.82 |
| HealthLink | HMO | $32.56 |
Inpatient
$22.20cash price (self-pay)
$37.00list price
$21.53–$65.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $21.53 |
| United Healthcare | Commercial | $24.49 |
| Anthem | Trad/PPO/HMO | $26.91 |
| Direct Health | Direct Health | $28.38 |
| SIHO | Commercial | $28.38 |
| Cigna | Commercial | $29.23 |
| Sagamore | Commercial | $29.23 |
| Corvel | Workers Comp | $30.34 |
| Aetna | Commercial | $31.01 |
| Anthem | HealthSync | $31.82 |
| HealthLink | HMO | $32.56 |
| Encore Prime | Commercial | $33.30 |
| Humana | Commercial | $33.30 |
| HealthLink | PPO | $34.41 |
| Molina | Medicaid | $37.00 |
| Underwriters Safety | Commercial | $37.00 |
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