Ondansetron injection at St. Luke's Health Memorial San Augustine. CPT J2405.

What St. Luke's Health Memorial San Augustine publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$5.85cash price (self-pay)

$125list price

$0.90–$1,043range insurers pay

Insurance plan	Negotiated rate
Cigna \| Commercial\|All Plans	$0.90
BCBS-TX \| Commercial\|Blue Premier	$1.26
BCBS-TX \| Commercial\|Blue Advantage HMO	$1.30
BCBS-TX \| Commercial\|HMO	$1.33
BCBS-TX \| Commercial\|PPO	$1.53
United \| Commercial\|Exchange	$22.56
United \| Commercial\|All Other Plans	$28.83
Aetna \| Commercial\|All Plans	$31.33
Angelina County \| Commercial\|All Plans	$50.14
Entrust \| Commercial\|All Plans	$50.14
PHCS \| Commercial\|All Plans	$85.22
Humana \| Commercial\|All Plans	$87.73
Multiplan \| Commercial\|All Plans	$87.73
Galaxy \| Commercial\|All Plans	$113

$5.85cash price (self-pay)

$125list price

$5.46–$1,159range insurers pay

Insurance plan	Negotiated rate
Cigna \| Commercial\|All Plans	$17.55
Aetna \| Commercial\|All Plans	$31.33
Entrust \| Commercial\|All Plans	$50.14
Humana \| Commercial\|All Plans	$87.73
Multiplan \| Commercial\|All Plans	$87.73
PHCS \| Commercial\|All Plans	$100
Galaxy \| Commercial\|All Plans	$113
United \| Commercial\|Exchange	$125

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