Ondansetron injection at UPMC Lititz. CPT J2405.
What UPMC Lititz publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$0.60cash price (self-pay)
$1.00list price
$0.09–$1.27range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare | $0.09 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.09 |
| Geisinger | Medicaid/CHIP | $0.09 |
| Highmark Wholecare (prev Gateway) | Medicaid | $0.09 |
| UPMC Health Plan | Managed Medicaid | $0.10 |
| UPMC Health Plan | CHIP | $0.11 |
| Prime Net | Managed Medicare | $0.19 |
| Capital Blue Cross | Medicare Advantage | $0.20 |
| Keystone Health Plan | Medicare Advantage | $0.20 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $0.21 |
| UPMC Work Partners | Workers Comp | $0.25 |
| Aetna | ACO | $0.39 |
| Prime Net | ACO | $0.39 |
| Prime Net | Legacy Commercial | $0.39 |
| Aetna | Commercial | $0.47 |
| Capital Blue Cross | CHIP | $0.47 |
| Capital Blue Cross | Commercial | $0.47 |
| Keystone Health Plan | Commercial | $0.47 |
| Prime Net | GateKeeper | $0.47 |
| Prime Net | NonGateKeeper | $0.47 |
| Preferred Healthcare System | Inter County Health Plan/Lancaster Gener | $0.55 |
| Geisinger | Commercial | $0.65 |
| UPMC Health Plan | Commercial | $0.70 |
| Prime Net | FH-Medical Rental | $0.72 |
| Preferred Healthcare System | PPO | $0.75 |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $0.85 |
| Cigna | Commercial | $1.27 |
Inpatient
$0.60cash price (self-pay)
$1.00list price
$0.26–$0.85range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC Work Partners | Workers Comp | $0.26 |
| Aetna | ACO | $0.37 |
| Prime Net | ACO | $0.37 |
| Prime Net | Legacy Commercial | $0.37 |
| Prime Net | NonGateKeeper | $0.44 |
| Aetna | Commercial | $0.45 |
| Prime Net | GateKeeper | $0.45 |
| Preferred Healthcare System | Inter County Health Plan/Lancaster Gener | $0.55 |
| United Healthcare | Commercial | $0.62 |
| Prime Net | FH-Medical Rental | $0.72 |
| Geisinger | Commercial | $0.72 |
| Preferred Healthcare System | PPO | $0.75 |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $0.85 |
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