Ketorolac injection, 15 mg at BSA Hospital. CPT J1885.
What BSA Hospital publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$7.50cash price (self-pay)
$75.00list price
$0.35–$63.75range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Star Superior Medicaid [1945] | Superior Chip [194501] | $7.94 |
| Star Superior Medicaid [1945] | Superior Star Medicaid [194500] | $22.33 |
| First Care Commercial [1371] | Firstcare HMO [137103] | $23.25 |
| United Healthcare Centennial Care [2250] | UHC Comm Mcaid Health Pla [ | $29.25 |
| Sunflower State Hlth Plan [3745] | Sunflower State Hlth Plan [374500] | $29.25 |
| Texas Childrens Health Plan [3995] | Texas Childrens Health Plan [3995 | $29.25 |
| Web Tpa [2115] | Web Tpa Healthcare Highways [211504] | $29.25 |
| Midland Pace Mcaid [3715] | Midland Pace Mcaid [371500] | $29.25 |
| Fidelis Care Of Nj Medicaid [3770] | Wellcare Medicaid [377500] | $29.25 |
| Amerigroup Commercial [5055] | Wellpoint Fka Amerigroup Mcare Sup [505 | $29.25 |
| Maxor Insurance [1610] | Maxor Insurance [161000] | $35.25 |
| Nreca [1735] | Nreca [173500] | $45.98 |
| Tml [1980] | Tml [198000] | $45.98 |
| Phcs [1780] | Phcs Multiplan [178000] | $52.50 |
| Phcs [1780] | Freedom Life [178009] | $52.50 |
| Phoenix Home Life [1785] | Phoenix Home Life [178500] | $52.50 |
| Northamerica Administrators [1725] | Northamerica Administrators [1725 | $52.50 |
| Principal Mutual Life [1845] | Principal Colorado Claims [184500] | $52.50 |
| Pan American Life Insurance Co [1770] | Pan American Life [177000] | $52.50 |
| Rh Administrators [1885] | Rh Administrators [188500] | $52.50 |
| Medishare Christian Care [1645] | Medishare Christian Care [164500] | $52.50 |
| Administrative Concepts [1005] | Administrative Concepts [100500] | $52.50 |
| Comcar Industries [1280] | Comcar Industries [128000] | $52.50 |
| Insurers Administrative Corp [1550] | Insurers Administrative Corp [15 | $52.50 |
| Americas Choice Health Plans [1090] | Americas Choice Health Plans [10 | $52.50 |
| Cherokee Insurance [1245] | Cherokee Insurance [124500] | $52.50 |
| National Association Of Letter Carriers [1695] | Nalc [169500] | $54.45 |
| Coresource [1315] | Coresource [131500] | $54.45 |
| Rural Carrier Benefit Plan [1895] | Rural Carrier Benefit Plan [189500 | $56.25 |
| Meritain Health [1655] | Meritain Health [165500] | $56.25 |
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