Ondansetron injection at UPMC Memorial. CPT J2405.

What UPMC Memorial 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–$9.23range 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
Capital Blue Cross \| CHIP	$0.11
Capital Blue Cross \| Commercial	$0.11
Keystone Health Plan \| Commercial	$0.11
UPMC Health Plan \| CHIP	$0.11
Prime Net \| Managed Medicare	$0.20
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	$0.36
Aetna \| ACO	$0.41
Prime Net \| ACO/Legacy Commercial	$0.41
Aetna \| Commercial	$0.48
Prime Net \| GateKeeper/NonGateKeeper	$0.48
Geisinger \| Commercial	$0.65
UPMC Health Plan \| Commercial	$0.70
Wellspan Population Health \| Commercial	$0.70
Prime Net \| FH-Medical Rental	$0.74
Multiplan \| PPO (Includes PHCS and Humana as Payers)	$0.85
Cigna \| Commercial	$1.27
Highmark BCBS of PA \| Medicare	$9.23

$0.60cash price (self-pay)

$1.00list price

$0.38–$0.85range insurers pay

Insurance plan	Negotiated rate
UPMC Work Partners \| Workers Comp	$0.38
Prime Net \| ACO/Legacy Commercial	$0.48
Aetna \| ACO	$0.49
Prime Net \| GateKeeper/NonGateKeeper	$0.56
Aetna \| Commercial	$0.57
United Healthcare \| Commercial	$0.62
Geisinger \| Commercial	$0.72
Prime Net \| FH-Medical Rental	$0.74
Multiplan \| PPO (Includes PHCS and Humana as Payers)	$0.85

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