Ketorolac injection, 15 mg at Pali Momi Medical Center. CPT J1885.
What Pali Momi Medical Center publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$17.15cash price (self-pay)
$28.59list price
$0.23–$46.50range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blended Rate UHC | All Products | $0.23 |
| UHC | All Products | $0.23 |
| Hmsa | Quest Abd | $0.30 |
| Hmsa | Quest Non-Abd | $0.30 |
| Ohana | Quest - Abd | $0.32 |
| Alohacare | Medicare Advantage | $0.34 |
| Hmsa | Medicare Advantage | $0.34 |
| Mdx | Humana Medicare | $0.34 |
| Mdx | UHC Medicare | $0.34 |
| Devoted | Medicare Advantage | $0.36 |
| Ohana | Medicare Advantage | $0.36 |
| Ohana | Quest - Non-Abd | $0.36 |
| Alohacare | Non-Abd - Pediatric | $0.46 |
| Alohacare | Non-Abd - Adult | $0.46 |
| Uha | All Products | $0.78 |
| Hmsa | All Products | $1.10 |
| Alohacare | Abd - Pediatric | $15.94 |
| Alohacare | Abd - Adult | $15.94 |
| Calvos | Select Care | $20.01 |
| Hwmg/Hmaa | All Products | $20.01 |
| Kaiser | All Products | $22.87 |
| Coventry | All Products | $24.30 |
| Mccp | All Products | $24.30 |
| Multiplan | All Products | $24.30 |
Inpatient
$17.15cash price (self-pay)
$28.59list price
$15.94–$46.50range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Multiplan | All Products | $22.87 |
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