Ketorolac injection, 15 mg at Tj Health Samson Community Hospital. CPT J1885.
What Tj Health Samson Community Hospital publishes for this service, straight from its standard-charges file, last updated April 23, 2026.
Outpatient / ER
$32.24cash price (self-pay)
$49.60list price
$0.34–$51.09range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $0.34 |
| Wellcare Mcr Adv - All Other Plans | Wellcare Mcr Adv - All Other Plan | $0.34 |
| Humana Mcr Adv - All Other Plans | Humana Mcr Adv - All Other Plans | $0.34 |
| Signature Health - All Plans | Signature Health - All Plans | $0.34 |
| Molina Mcr Adv | Molina Mcr Adv | $0.35 |
| Devoted Mcr Adv - All Plans | Devoted Mcr Adv - All Plans | $0.36 |
| Molina Marketplace - All Other Plans | Molina Marketplace - All Other | $0.51 |
| Blue Cross Path HMO | Blue Cross Path HMO | $0.56 |
| Blue Cross PPO | Blue Cross PPO | $0.56 |
| Blue Cross HMO | Blue Cross HMO | $0.56 |
| Blue Cross Path Hpn/PPO | Blue Cross Path Hpn/PPO | $0.56 |
| Blue Cross Trad - All Other Plans | Blue Cross Trad - All Other Plans | $0.56 |
| UHC All Payer - All Plans | UHC All Payer - All Plans | $38.54 |
| Blue Cross Mcr Select | Blue Cross Mcr Select | $42.16 |
| Center Care Select - All Plans | Center Care Select - All Plans | $42.16 |
| Phcs/Multiplan - All Plans | Phcs/Multiplan - All Plans | $46.62 |
| First Health - All Plans | First Health - All Plans | $47.12 |
| Caresource - All Plans | Caresource - All Plans | $49.60 |
| Humana Mcaid | Humana Mcaid | $49.60 |
| Wellcare Mcaid | Wellcare Mcaid | $49.60 |
| Aetna Better Health Mcaid - All Plans | Aetna Better Health Mcaid - Al | $49.60 |
| Molina Mcaid | Molina Mcaid | $51.09 |
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