Ketorolac injection, 15 mg at San Gabriel Valley Medical Center. CPT J1885.
What San Gabriel Valley Medical Center publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
$22.50cash price (self-pay)
$75.00list price
$0.33–$75.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Health of California | Aetna | $0.68 |
| Blue Shield of California | Blue Shield | $1.85 |
| Blue Shield of California | Blue Shield Value Network Covered Californ | $1.85 |
| AIDS Healthcare Foundation | AIDS Hlth Fndn/Positive Hlth Mcal | $4.79 |
| AltaMed Health Network | AltaMed Health Network Medi-Cal | $4.79 |
| Avanti | Avanti Medi-cal | $4.79 |
| Beverly Hospital | BEVERLY HOSPITAL MCL | $4.79 |
| Emanate Health | Emanate Health Medi-Cal | $4.79 |
| Healthy Way LA | Healthy Way LA | $4.79 |
| Hollywood Presbyterian Adv Med Mcal | Hollywood Presbyterian Adv Med M | $4.79 |
| Hollywood Presbyterian Medpoint Mcal | Hollywood Presbyterian Medpoint | $4.79 |
| Medi-Cal/Medicaid | Medi-Cal/Medicaid | $4.79 |
| Non Contracting Medi Cal | Other Non Contracting Medi Cal | $4.79 |
| Blue Cross Medi-Cal Managed Care | Blue Cross Healthy Families | $5.27 |
| LA Care Health Plan | LA Care Healthy Kids and Medi-Cal Managed Care | $5.47 |
| Blue Cross Medi-Cal Managed Care | Blue Cross Medi-Cal | $5.71 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH PLAN MCAL | $6.71 |
| Care 1st Health Plan | Care 1st Health Plan Healthy Families | $18.75 |
| Alignment Healthplan | Alignment Healthplan Allied Pacific Sr Cap | $26.25 |
| Brand New Day | Brand New Day Allied Pacific SR Cap | $26.25 |
| Clever Care | Clever Care Accountable Phys Cap | $26.25 |
| Clever Care | Clever Care Allied Phys Cap | $26.25 |
| AIDS Healthcare Foundation | AIDS Healthcare Foundation | $30.00 |
| Health Net | Health Net Enhanced PPO | $36.15 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH HMO | $37.50 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH SENIOR | $37.50 |
| Facey Medical | Facey Medical | $37.50 |
| Health Net | Health Net Healthy Families/Kids/AIM | $43.57 |
| Central Health Plan | Central Health Plan HMO | $45.00 |
| Community Care Network | Community Care Network/First Health | $48.75 |
Inpatient
$22.50cash price (self-pay)
$75.00list price
$15.75–$75.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Health of California | Aetna | $15.75 |
| Affiliated Health Fund | Affiliated Health Fund | $26.25 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH HMO | $37.50 |
| ChoiceCare Network | ChoiceCare | $41.25 |
| Beech Street | Beech Street PPO | $60.00 |
| MultiPlan | MultiPlan PPO | $67.50 |
| PPO Next | PPO Next | $67.50 |
| Other Non Contracted Commercial | Other Non Contracted Commercial | $75.00 |
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