Ketorolac injection, 15 mg at St. Luke's Boise Standard Charges. CPT J1885.
What St. Luke's Boise Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$2.70cash price (self-pay)
$16.19list price
$0.33–$27.57range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commercial [1028] | Hb Tv Va Ccn | $0.33 |
| Medicare Advantage Generic [1019] | Hb Tv Medicare Advantage | $0.33 |
| Medicare Advantage Generic [1019] | Hb Tv Molina Mmcp | $0.33 |
| Medicare Advantage Molina [1053] | Hb Tv Molina Mmcp | $0.33 |
| Blue Cross/Medicare Advantage [1009] | Hb Tv Bci True & Secure Med Adv | $0.34 |
| Medicare Advantage Generic [1019] | Hb Tv Molina Med Adv | $0.34 |
| Medicare Advantage Molina [1053] | Hb Tv Molina Med Adv | $0.34 |
| Medicare Advantage Aetna [1017] | Hb Tv Aetna Med Adv | $0.37 |
| Cigna [1062] | Hb Tv Cigna | $0.74 |
| Commercial [1028] | Hb Tv Cigna | $0.74 |
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Tv Slhp St Lukes | $1.07 |
| Blue Cross Idaho [1007] | Hb Tv Slhp Blue Cross Carepoint Qhp | $1.07 |
| Blue Cross Idaho [1007] | Hb Tv Slhp Blue Cross Large Group | $1.07 |
| Commercial [1028] | Hb Tv Slhp Mountain Health Coop | $1.07 |
| Commercial [1028] | Hb Tv Slhp Select Health | $1.07 |
| Commercial [1028] | Hb Tv Slhp Select Health Qhp | $1.07 |
| Commercial [1028] | Hb Tv H2b | $12.14 |
| H2b [1068] | Hb Tv H2b | $12.14 |
| Pacificsource [1020] | Hb Tv Pacificsource PPO Voyager | $12.14 |
| Aetna [1021] | Hb Tv Bp Aetna | $12.95 |
| Commercial [1028] | Hb Tv Bp Aetna | $12.95 |
| Commercial [1028] | Hb Tv Multiplan Primary Network | $12.95 |
| Webtpa [1071] | Hb Tv Bp Aetna | $12.95 |
| Blue Cross Federal [1008] | Hb Tv Bci PPO Fep | $13.28 |
| Blue Cross Idaho [1007] | Hb Tv Bci PPO Fep | $13.28 |
| Commercial [1028] | Hb Tv United Healthcare | $13.28 |
| Geha [1065] | Hb Tv United Healthcare | $13.28 |
| United Healthcare [1025] | Hb Tv United Healthcare | $13.28 |
| United Medical Resources [1051] | Hb Tv United Healthcare | $13.28 |
| Commercial [1028] | Hb Tv Ccn First Health | $13.36 |
Inpatient
$2.70cash price (self-pay)
$16.19list price
$1.76–$24.50range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Advantage Pacificsource [1039] | Hb Tv Slhp Pacificsource Med | $10.52 |
| Cigna [1062] | Hb Tv Cigna | $12.95 |
| Commercial [1028] | Hb Tv Cigna | $12.95 |
| Commercial [1028] | Hb Tv Va Ccn | $12.95 |
| Providence [1022] | Hb Tv Cigna | $12.95 |
| Veterans Affairs [1056] | Hb Tv Va Ccn | $12.95 |
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