Ondansetron injection at Intermountain Health Primary Children's Hospital. CPT J2405.
What Intermountain Health Primary Children's Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$2.85cash price (self-pay)
$3.80list price
$0.09–$3.34range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SelectHealth | Medicaid | $0.81 |
| Donor Connect | Other | $1.51 |
| Aetna | Standard | $3.19 |
| BYU Athletics | Commercial | $3.19 |
| Campbell Scientific | Commercial | $3.19 |
| Cigna | HMO | $3.19 |
| Cigna | Open Access Flex | $3.19 |
| Cigna | PPO/EPO | $3.19 |
| Cigna | Utah Connect/Local Plus | $3.19 |
| Deseret Mutual | All Other | $3.19 |
| EMI Health | Mint | $3.19 |
| EMI Health | Network Care | $3.19 |
| EMI | Commercial | $3.19 |
| First Choice of the Midwest | Commercial | $3.19 |
| First Choice | Commercial | $3.19 |
| Franklin County | Commercial | $3.19 |
| Global Excel | Commercial | $3.19 |
| Health Utah | Commercial | $3.19 |
| Humana | Commercial | $3.19 |
| Hygeia Corporation | Commercial | $3.19 |
| Juniper Systems | Commercial | $3.19 |
| LW Miller | Commercial | $3.19 |
| Managed Care Admin | Commercial | $3.19 |
| MedCare International | Commercial | $3.19 |
| Molina | CHIP | $3.19 |
| Molina | Marketplace | $3.19 |
| MotivHealth | Commercial | $3.19 |
| PEHP | All Plans | $3.19 |
| PEHP | Summit Exclusive | $3.19 |
| Prodegi Corp Benefit | Commercial | $3.19 |
Inpatient
$2.85cash price (self-pay)
$3.80list price
$1.37–$3.34range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $1.37 |
| American Health | Medicare Adv UT HMO I-SNP | $2.17 |
| Molina | Medicare Advantage | $2.28 |
| Molina | Medicare Choice Care HMO | $2.28 |
| Molina | Medicare Complete Care HMO SNP | $2.28 |
| AWH Connected | Connected Utah | $2.70 |
| Aetna | Connected | $2.70 |
| Aetna | Extended | $2.70 |
| Aetna | Standard | $2.70 |
| BYU Athletics | Commercial | $2.70 |
| Campbell Scientific | Commercial | $2.70 |
| Cigna | HMO | $2.70 |
| Cigna | Open Access Flex | $2.70 |
| Cigna | PPO/EPO | $2.70 |
| Cigna | Utah Connect/Local Plus | $2.70 |
| Deseret Mutual | All Other | $2.70 |
| EMI Health | Mint | $2.70 |
| EMI Health | Network Care | $2.70 |
| EMI | Commercial | $2.70 |
| First Choice of the Midwest | Commercial | $2.70 |
| First Choice | Commercial | $2.70 |
| Franklin County | Commercial | $2.70 |
| Global Excel | Commercial | $2.70 |
| Health Utah | Commercial | $2.70 |
| Humana | Commercial | $2.70 |
| Hygeia Corporation | Commercial | $2.70 |
| Juniper Systems | Commercial | $2.70 |
| LW Miller | Commercial | $2.70 |
| Managed Care Admin | Commercial | $2.70 |
| MedCare International | Commercial | $2.70 |
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All common services at Intermountain Health Primary Children's Hospital