Ketorolac injection, 15 mg at Good Samaritan Hospital. CPT J1885.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$181cash price (self-pay)
$185list price
$0.33–$186range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Physicians Medical Group | MCD | $0.33 |
| Blue Shield | TRICARE | $0.34 |
| Health Net | Tricare | $0.34 |
| Anthem | Medi-Cal | $0.36 |
| Physician Health Network | MGMCD | $0.36 |
| United | AllPayerAppendix | $0.56 |
| Cigna | LocalPlus | $0.62 |
| Cigna | HMO | $0.66 |
| Cigna | POS | $0.66 |
| Cigna | PPO | $0.66 |
| MedCare Partners | MGMCR | $27.73 |
| Santa Clara Family Health Plan | Medicaid | $35.13 |
| United | OptionsPPO | $47.14 |
| United | GlobalBenefitPlan | $83.19 |
| Santa Clara IPA COMM | COMM | $92.44 |
| Santa Clara IPA MCR | MCR | $92.44 |
| NX Health Network | COMM | $111 |
| Sutter Select | COMM | $111 |
| ChoiceCare Humana | COMM | $129 |
| First Health | COMM | $141 |
| Cigna BH | COMMBH | $148 |
| HealthSmart | WCOMP | $148 |
| Intercontinental Corporation | COMM | $148 |
| MultiPlan | Complementary | $148 |
| PHA Pacific Health Alliance | COMM | $148 |
| PPO Next | COMM | $148 |
| PPO Next | PPO | $148 |
| First Health | WCOMP | $185 |
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