Ketorolac injection, 15 mg at CHI Health Missouri Valley. CPT J1885.
What CHI Health Missouri Valley publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$48.76cash price (self-pay)
$99.50list price
$0.70–$97.51range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark | Commercial|HMO | $0.70 |
| Wellmark | Commercial|PPO | $0.70 |
| Humana | Medicare|All Plans | $34.83 |
| Medica | Medicare|All Plans | $34.83 |
| PACE | Medicare|All Plans | $34.83 |
| United | Medicare|All Plans | $34.83 |
| Centene | Medicare|All Plans | $35.53 |
| Amerigroup | Medicare|All Plans | $36.57 |
| Great Plains | Medicare|All Plans | $36.57 |
| United | Medicaid|Community Plan | $42.79 |
| Amerigroup | Medicaid|All Plans | $43.65 |
| Total Care | Medicaid|All Plans | $43.65 |
| IAMolina | Medicaid|All Plans | $44.50 |
| AMPS | Commercial|All Plans | $77.32 |
| BCBS - NE | Commercial|BluePrint | $89.80 |
| Medica | Commercial|All Other Plans | $90.55 |
| Medica | Commercial|CHI Health | $90.55 |
| BCBS - NE | Commercial|All Other Plans | $94.53 |
| Greater Omaha Packing | Commercial|Broad Network | $95.52 |
| Greater Omaha Packing | Commercial|Narrow Network | $95.52 |
| Medica | Commercial|ACO | $95.52 |
| Medica | Commercial|Open Access | $95.52 |
| Midlands Choice | Commercial|Premier | $95.52 |
| Midlands Choice | Commercial|Standard | $95.52 |
| Millard Public Schools | Commercial|Broad Network | $95.52 |
| Millard Public Schools | Commercial|Narrow Network | $95.52 |
| One World | Commercial|Broad Network | $95.52 |
| One World | Commercial|Narrow Network | $95.52 |
| QuikTrip | Commercial|All Plans | $95.52 |
| Timpte | Commercial|Broad Network | $95.52 |
Inpatient
$48.76cash price (self-pay)
$99.50list price
$56.72–$97.51range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark | Commercial|HMO | $56.72 |
| Wellmark | Commercial|PPO | $56.72 |
| BCBS - NE | Commercial|BluePrint | $89.80 |
| Medica | Commercial|All Other Plans | $90.55 |
| Medica | Commercial|CHI Health | $90.55 |
| BCBS - NE | Commercial|All Other Plans | $94.53 |
| Greater Omaha Packing | Commercial|Broad Network | $95.52 |
| Greater Omaha Packing | Commercial|Narrow Network | $95.52 |
| Medica | Commercial|ACO | $95.52 |
| Medica | Commercial|Open Access | $95.52 |
| Midlands Choice | Commercial|Premier | $95.52 |
| Midlands Choice | Commercial|Standard | $95.52 |
| Millard Public Schools | Commercial|Broad Network | $95.52 |
| Millard Public Schools | Commercial|Narrow Network | $95.52 |
| One World | Commercial|Broad Network | $95.52 |
| One World | Commercial|Narrow Network | $95.52 |
| QuikTrip | Commercial|All Plans | $95.52 |
| Timpte | Commercial|Broad Network | $95.52 |
| United | Commercial|All Plans | $95.52 |
| MultiPlan | Commercial|All Plans | $97.51 |
| PHCS | Commercial|All Plans | $97.51 |
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