Ketorolac injection, 15 mg at Gundersen Palmer Lutheran Hospital and Clinic. CPT J1885.
What Gundersen Palmer Lutheran Hospital and Clinic publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$11.88cash price (self-pay)
$20.00list price
$0.33–$20.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | Fully Insured | $0.33 |
| Quartz | All Products | $0.33 |
| Quartz | Level Funded | $0.33 |
| Quartz | Self Funded | $0.33 |
| Quartz | All Other Self Funded | $0.33 |
| Alliance | Premier/All Products | $1.07 |
| Alliance | Comprehensive/All Products | $1.07 |
| UHC | All Payer Appendix | $9.92 |
| Health Partners | Medicaid HMO | $10.00 |
| Wellmark | All Products | $10.20 |
| Aetna | Medicare Advantage | $10.40 |
| Amerigroup | Medicare Advantage | $10.40 |
| Health Partners | Medicare Advantage | $10.40 |
| Humana | Medicare Advantage | $10.40 |
| Iowa Total Care | Medicaid | $10.40 |
| Managed Health Service | Managed Medicaid | $10.40 |
| Quartz | Medicare Advantage | $10.40 |
| Quartz | Medicaid_Badgercare | $10.40 |
| UHC | Medicare Advantage | $10.40 |
| Wellmark | Medicare Advantage | $10.40 |
| UCARE | Non-Dually Eligible | $11.00 |
| UCARE | Dually Eligible | $11.00 |
| UCARE | MSHO/Minnesota Special Needs | $11.00 |
| Health Partners | Medicare Cost | $12.00 |
| Medical Associates | CAH Specific | $16.00 |
| Trilogy | All Products | $16.00 |
| UCARE | Qualified Health Plan | $16.00 |
| Aetna | All Products | $16.40 |
| Aspirus Arise Health | All Products | $16.60 |
| Allied National | Core Value Programs | $17.00 |
Inpatient
$11.88cash price (self-pay)
$20.00list price
$9.92–$19.40range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $11.78 |
| Wellmark | All Products | $16.60 |
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All common services at Gundersen Palmer Lutheran Hospital and Clinic