Ondansetron injection at Froedtert Holy Family Memorial Hospital. CPT J2405.
What Froedtert Holy Family Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$18.66cash price (self-pay)
$58.93list price
$0.10–$73.88range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Network Health Plan | HMO | $0.10 |
| United Healthcare | Manitowoc Schools | $0.10 |
| United Healthcare | Nexus | $0.10 |
| United Healthcare Choice/Navigate | APA | $0.10 |
| United Healthcare Options | PPO | $0.10 |
| Anthem Blue Cross Blue Shield (Healthlink) | HMO/PPO | $0.12 |
| Dean Health Plan | All Plans | $16.96 |
| Medical College of Wisconsin | Employee Plan | $19.45 |
| Centivo | WI 2 Median | $23.57 |
| Centivo | WI 1 Broad | $27.11 |
| Network Health Plan | ACA | $32.41 |
| Health Payment Systems | All Contracted Commercial Plans | $33.24 |
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $35.36 |
| Chorus Community Health Plan | Marketplace Plans | $37.89 |
| Health Partners | All Contracted Commercial Plans | $38.30 |
| Trilogy | All Contracted Commercial Plans | $38.89 |
| Cigna | All Contracted Commercial Plans | $42.43 |
| WPS Health Plan | All Contracted Commercial Plans | $43.60 |
| Aspirus | Marketplace Plans | $47.14 |
| HealthEos | All Contracted Commercial Plans | $47.14 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $47.14 |
| Preferred One | All Contracted Commercial Plans | $47.14 |
| Security Health Plan | All Contracted Commercial Plans | $47.14 |
| HealthSmart | All Contracted Commercial Plans | $48.92 |
| First Health Network | All Contracted Commercial Plans | $51.86 |
Inpatient
$18.66cash price (self-pay)
$58.93list price
$16.96–$73.88range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield (Healthlink) | HMO/PPO | $29.47 |
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $35.36 |
| Trilogy | All Contracted Commercial Plans | $38.89 |
| Cigna | All Contracted Commercial Plans | $42.43 |
| Aspirus | Marketplace Plans | $47.14 |
| HealthEos | All Contracted Commercial Plans | $47.14 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $47.14 |
| Preferred One | All Contracted Commercial Plans | $47.14 |
| Security Health Plan | All Contracted Commercial Plans | $47.14 |
| HealthSmart | All Contracted Commercial Plans | $48.92 |
| First Health Network | All Contracted Commercial Plans | $51.86 |
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All common services at Froedtert Holy Family Memorial Hospital