Ketorolac injection, 15 mg at Memorial Hospital of South Bend. CPT J1885.
What Memorial Hospital of South Bend publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$29.25cash price (self-pay)
$45.00list price
$0.16–$45.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| McLaren | MI Medicaid | $0.16 |
| UHC | MI Medicaid | $0.16 |
| Anthem | Exchange | $0.30 |
| Anthem | Medicare Advantage | $0.30 |
| Humana | Medicare Advantage | $0.30 |
| PACE | Medicare | $0.30 |
| UHC | Medicare Advantage | $0.30 |
| Caresource | Exchange | $0.48 |
| Anthem | Workers Compensation | $0.57 |
| Anthem | Commercial (Granger) | $1.09 |
| Devoted Healthcare | Medicare Advantage | $9.00 |
| Anthem | Commercial (excludes Granger) | $9.05 |
| Anthem | HealthSync | $9.05 |
| Aetna | Medicare Advantage | $20.25 |
| CHA | Employer Group 4 | $27.00 |
| Immergrun | Commercial | $27.00 |
| MHS | Exchange | $29.25 |
| Cigna | OAP | $31.50 |
| UHC | Commercial | $32.49 |
| Aetna | Commercial | $33.12 |
| Multiplan | Commercial | $33.30 |
| CHA | Employer Group 5 | $33.75 |
| Humana | Commercial | $34.65 |
| Plain Church | Commercial | $36.00 |
| CHA | Employer Group 6 | $36.00 |
| Cigna BH | Commercial | $36.00 |
| Cigna | PPO | $36.90 |
| Heartland | Hospice | $45.00 |
Inpatient
$29.25cash price (self-pay)
$45.00list price
$9.00–$36.90range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Healthcare | Medicare Advantage | $9.00 |
| Multiplan | Commercial | $29.25 |
| Cigna | OAP | $31.50 |
| UHC | Commercial | $32.49 |
| Humana | Commercial | $32.85 |
| Aetna | Commercial | $33.12 |
| CHA | Employer Group 5 | $33.75 |
| CHA | Employer Group 6 | $36.00 |
| Cigna BH | Commercial | $36.00 |
| Immergrun | Commercial | $36.00 |
| Plain Church | Commercial | $36.00 |
| Cigna | PPO | $36.90 |
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