Ketorolac injection, 15 mg at Dorminy Medical Center. CPT J1885.
What Dorminy Medical Center publishes for this service, straight from its standard-charges file, last updated May 6, 2026.
Outpatient / ER
$5.00cash price (self-pay)
$10.00list price
$0.10–$9.50range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Pathway | Pathway | $0.10 |
| Anthem Blue Cross HMO | HMO | $0.11 |
| Anthem BCBS PPO | PPO | $0.11 |
| HealthSmart | All Commercial Plans | $7.50 |
| Aetna Commercial | PPO/HMO | $8.00 |
| Provider Network of America | All Commercial Plans | $8.50 |
| Principal Edge Network | All Commercial Plans | $8.70 |
| United HealthCare Commercial | PPO/HMO | $8.70 |
| Cigna Commercial | PPO/HMO | $8.80 |
| Humana ChoiceCare | All Commercial Plans | $8.80 |
| Novanet | All Commercial Plans | $9.00 |
| Unicare | All Commercial Plans | $9.00 |
| PHCS | All Commercial Plans | $9.00 |
| MultiPlan | PPO/HMO | $9.00 |
| Three Rivers Provider Network | All Commercial Plans | $9.50 |
Inpatient
$5.00cash price (self-pay)
$10.00list price
$7.50–$9.50range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| HealthSmart | All Commercial Plans | $7.50 |
| Aetna Commercial | PPO/HMO | $8.00 |
| Provider Network of America | All Commercial Plans | $8.50 |
| Principal Edge Network | All Commercial Plans | $8.70 |
| United HealthCare Commercial | PPO/HMO | $8.70 |
| Cigna Commercial | PPO/HMO | $8.80 |
| Humana ChoiceCare | All Commercial Plans | $8.80 |
| Novanet | All Commercial Plans | $9.00 |
| Unicare | All Commercial Plans | $9.00 |
| PHCS | All Commercial Plans | $9.00 |
| MultiPlan | PPO/HMO | $9.00 |
| Three Rivers Provider Network | All Commercial Plans | $9.50 |
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