Ondansetron injection at Medical City Lewisville Hospital. CPT J2405.
What Medical City Lewisville Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$497cash price (self-pay)
$497list price
$0.09–$497range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | Tricare | $0.09 |
| United | AllPayerAppendix | $0.15 |
| United | NarrowNetworkIndivExchange | $0.15 |
| United | SmallGroup | $0.15 |
| BCBS | BlueAdvantageHMO | $2.04 |
| BCBS | MyBlueHealth | $2.04 |
| BCBS | BlueEssentials | $2.98 |
| BCBS | BlueEssentialsAccess | $2.98 |
| BCBS | Eposoa | $3.13 |
| BCBS | PPO | $3.27 |
| Cigna | LocalPlus | $5.02 |
| Cigna | NewBusiness | $5.03 |
| Cigna | HMO | $5.61 |
| Cigna | NetworkBenefit | $5.61 |
| Cigna | OpenAccessPlus | $5.61 |
| Cigna | AllOther | $7.10 |
| Cigna | IFP | $67.15 |
| Cigna | QHP | $69.64 |
| Superior | EPO | $99.49 |
| Healthcare Highways | CityofPlano | $168 |
| BCBS | Traditional | $206 |
| City of McKinney | COMM | $224 |
| Molina Healthcare | HIX | $249 |
| National ChoiceCare | WCOMP | $249 |
| Aetna | ASA | $251 |
| Aetna | WCOMP | $274 |
| PC Texas Partners | WCOMP | $274 |
| Physicians Coop of TX | MGMCR | $274 |
| Rockport Health Group | WORKERSCOMP | $274 |
| Aetna Coventry First Health | COMM | $285 |
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