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 January 1, 2025.
Outpatient / ER
$2.29cash price (self-pay)
$4.23list price
$0.27–$2,632range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid/Peachcare | $0.27 |
| UHC | Medicare Advantage | $1.14 |
| Aetna | Medicare Advantage | $1.14 |
| Ambetter | Medicare Advantage | $1.14 |
| Anthem BCBS | Medicare Advantage | $1.14 |
| Care Improvement Plus | Medicare Advantage | $1.14 |
| Caresource | Medicare Advantage | $1.14 |
| Centene | Medicare Advantage | $1.14 |
| Cigna HealthSpring | Medicare Advantage | $1.14 |
| Coventry | Medicare Advantage | $1.14 |
| Eon Health Plan | Medicare Advantage | $1.14 |
| Humana | Medicare Advantage | $1.14 |
| Kaiser Permanente | Medicare Advantage | $1.14 |
| Molina | Medicare Advantage | $1.14 |
| Pruitthealth Premier | Medicare Advantage | $1.14 |
| Todays Options PFFS | Medicare Advantage | $1.14 |
| Todays Options PPO | Medicare Advantage | $1.14 |
| VACCN United | Veterans Affairs | $1.14 |
| Wellcare | Medicare Advantage | $1.14 |
| Anthem | Pathway Program | $1.43 |
| Anthem | PPO | $3.06 |
| Anthem | HMO | $3.06 |
| COVENTRY | All Products | $3.17 |
| First Health | All Products | $3.17 |
| Humana | All Products | $3.17 |
| PHCS | All Products | $3.17 |
| Aetna | All Products | $3.38 |
| MERITAIN | All Products | $3.38 |
| Cigna | All products | $3.47 |
| Multiplan | All Products | $3.64 |
Inpatient
$2.29cash price (self-pay)
$4.23list price
$0.68–$7.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Pathway Program | $0.82 |
| Anthem | HMO | $2.15 |
| Anthem | PPO | $2.15 |
| NOVA | All Products | $3.60 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.