Ondansetron injection at Pennsylvania Hospital. CPT J2405.
What Pennsylvania Hospital publishes for this service, straight from its standard-charges file, last updated March 20, 2026.
Outpatient / ER
$2.00cash price (self-pay)
$5.00list price
$0.09–$75.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $0.09 |
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $0.09 |
| UPMC | UPMC Medicaid | $0.10 |
| Independence Blue Cross/Personal Choice | Personal Choice-IBC PPO | $0.12 |
| Keystone HMO Proactive | Keystone HMO Proactive | $0.12 |
| Independence Blue Cross/Keystone Health Plan East | Keystone Health Pl | $0.12 |
| PA Health and Wellness Medicaid | PA Health and Wellness Medicaid | $0.90 |
| UnitedHealthcare | UnitedHealthcare Compass Exchange | $1.02 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $1.15 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $1.30 |
| US Family Health Plan | US Family Health Plan | $1.75 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $1.75 |
| Qualcare | Qualcare | $1.90 |
| UnitedHealthcare New Business | UnitedHealthcare New Business | $1.94 |
| Wissahickon Hospice | Wissahickon Hospice | $2.00 |
| Pgm - Chop | Pgm - Chop | $2.00 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $2.02 |
| Olympus | Olympus | $2.43 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $2.50 |
| Penn Global Medicine | International GMMI | $2.50 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $3.00 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $3.25 |
| PGM - Embassy of Qatar | PGM - Embassy of Qatar | $3.25 |
| PGM - Embassy of the United Emirates/IPC | PGM - Embassy of the United | $3.50 |
| Preferred Care | Preferred Care | $4.00 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $4.00 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $4.00 |
| Intergroup | Intergroup | $4.00 |
| Workers Compensation | Workers Compensation | $5.00 |
| UPMC | UPMC Medicare | $5.00 |
Inpatient
$2.00cash price (self-pay)
$5.00list price
$0.34–$75.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Horizon NJ Health | Horizon NJ Health | $0.84 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $1.15 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $1.30 |
| Devon | Devon Premier | $1.90 |
| Pgm - Chop | Pgm - Chop | $2.00 |
| Coventry | HealthAmerica/Coventry SEPA | $2.00 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $2.45 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $2.50 |
| First Health Global | First Health Global | $2.50 |
| Coventry | Coventry of Delaware | $2.55 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $3.00 |
| Health Net | Health Net | $3.00 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $3.25 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $3.50 |
| Preferred Care | Preferred Care | $4.00 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $4.00 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $4.00 |
| Intergroup | Intergroup | $4.00 |
| Humana Choice Care | Humana Choice Care | $4.00 |
| Health America/CCN | First Health/ Coventry National | $4.00 |
| Devon Health Services Inc | Devon Health Services | $4.00 |
| UPMC | UPMC Medicaid | $5.00 |
| United Behavioral Health | United Behavioral Health | $5.00 |
| Quest Behavioral Health | Quest Behavioral Health | $5.00 |
| Managed Medicaid Other | Managed Medicaid Other | $5.00 |
| International PFS | International PFS | $5.00 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $5.00 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $5.00 |
| Health Partners | Health Partners Medicaid | $5.00 |
| Community Behavioral Health | Community Behavioral Health | $5.00 |
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