Ketorolac injection, 15 mg at Mercy Orthopedic Hospital Fort Smith. CPT J1885.
What Mercy Orthopedic Hospital Fort Smith publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$5.80cash price (self-pay)
$11.00list price
$0.33–$44.22range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Home State Medicaid Contracted [320189] | Hb Ftsm Managed Mo Mcd | $2.20 |
| Medicaid [20240] | Hb Ftsm Mo Medicaid | $2.20 |
| MERCY INTERFACILITY [20513] | HB FTSM Inter-Facility CCR New 6.1.25 | $2.42 |
| Yuzu Health Contracted [320521] | Hb Ftsm Dec Level Health - New 01.01 | $3.85 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Tall Tree | $3.85 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Schaefer Qcg | $3.85 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Bartel | $3.85 |
| Edison Health Solutions Contracted [320502] | Hb Ftsm Dec Woodard | $3.85 |
| Aither Health Contracted [320449] | Hb Ftsm Dec Woodard | $3.85 |
| Aither Health Contracted [320449] | Hb Ftsm Dec Laclede - New 07.01.25 | $3.85 |
| Qual Choice Contracted [320324] | Hb Ftsm,Wldar,Ozkar,Prsar, Bnvar Qua | $4.40 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Show Me | $5.50 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Town And Country | $5.50 |
| Show-Me Health Administrators Contracted [320483] | Hb Ftsm Rogr Dec A | $5.50 |
| 90 Degree Benefits Contracted [320436] | Hb Ftsm Dec Show Me | $5.50 |
| Healthlink Contracted [320179] | Hb Ftsm Rogr Cah Dec Sapaugh | $6.60 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Herman | $6.60 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Quiktrip Co | $6.60 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Rogr Dec Easter Seal | $6.60 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Rogr Dec City Of Jac | $6.60 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Rogr Cah Dec Sapaugh | $6.60 |
| Ebms [20493] | Hb Ftsm Crader | $6.60 |
| Auxiant Contracted [320462] | Hb Ftsm Rogr Dec City Of Jackson | $6.60 |
| Auxiant Contracted [320462] | Hb Ftsm Rogr Dec Buchheit | $6.60 |
| Ebms Contracted [320493] | Hb Ftsm Crader | $6.60 |
| REFLECT HEALTH CONTRACTED [320492] | HB FTSM DEC WWWood Products | $6.60 |
| Imagine 360 Contracted [320494] | Hb Ftsm Rogr Dec Robinson Constructi | $6.60 |
| Municipal Health Plan Contracted [320271] | Hb Ftsm Municipal Health | $6.60 |
| Preferred Health Plan Contracted [320522] | Hb Ftsm Net Affiliation | $7.15 |
| Personify Health Contracted [320051] | Hb Ftsm Net Affiliation | $7.15 |
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