Ketorolac injection, 15 mg at Fairview Hospital. CPT J1885.
What Fairview Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$8.02cash price (self-pay)
$12.01list price
$0.30–$294range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Comm HNE HMO | Comm HNE HMO | $0.41 |
| Health New England | Comm HNE | $0.43 |
| Comm HNE PPO | Comm HNE PPO | $0.43 |
| Other Government | Tri Tricare | $1.73 |
| Medicare | MCR Traditional Medicare | $1.78 |
| Medicare | MCRManaged Medicare HMO | $1.78 |
| Fallon | MCRManaged Fallon Medicare Advantage | $1.79 |
| Fallon | MCRManaged Fallon Medicare SCO | $1.80 |
| Hospice | Comm Hospice | $1.81 |
| Other Government | MCR Miscellaneous | $1.81 |
| Blue Cross | MCRManaged Blue Cross VT Medicare HMO | $1.81 |
| CommCare Alliance | MCRManaged CCA One Care | $1.81 |
| Other Government | MCRManaged USA Family | $1.81 |
| Other Government | MCRManaged VA | $1.81 |
| United Healthcare | Oth United VACCN | $1.81 |
| Health New England | MCRManaged HNE Medicare Advantage | $1.82 |
| Point32Health | Comm Harvard | $1.91 |
| Unicare | Comm Wellpoint (Unicare) | $2.91 |
| Comm Fallon QHP | Comm Fallon QHP | $3.17 |
| Aetna | Comm Aetna | $3.35 |
| Fallon | MCDManaged Fallon Medicaid ACO | $4.89 |
| Point32Health | Comm Tufts QHPSUB (Network) | $6.96 |
| Workers Comp | WC Workers Comp | $7.65 |
| Allways NHP | Comm NHP | $7.77 |
| United Healthcare | Comm United BH | $7.81 |
| Point32Health | Comm Tufts QHPNONSUB (Network) | $8.02 |
| Blue Cross | Comm Blue Cross VT PPO | $9.20 |
| United Healthcare | Comm UnitedHealthcare | $10.33 |
| Capital District Physicians' Health Plan | Comm CDPHP | $10.81 |
| Cigna | Comm Cigna Carelink | $10.81 |
Inpatient
$8.02cash price (self-pay)
$12.01list price
$4.77–$14.80range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Point32Health | Comm Tufts QHPSUB (Network) | $6.79 |
| Point32Health | MCDManaged Tufts (Network) | $6.79 |
| Workers Comp | WC Workers Comp | $7.65 |
| Allways NHP | Comm NHP | $7.77 |
| Point32Health | Comm Tufts QHPNONSUB (Network) | $7.79 |
| Blue Cross | Comm Blue Cross VT PPO | $8.65 |
| Aetna | Comm Aetna | $9.06 |
| Point32Health | Comm Tufts | $9.51 |
| United Healthcare | Comm UnitedHealthcare | $10.33 |
| Capital District Physicians' Health Plan | Comm CDPHP | $10.81 |
| MVP | Comm MVP | $10.81 |
| Oxford | Comm Oxford | $10.81 |
| Connecticare | Comm Connecticare | $11.41 |
| Consolidated Health Plans | Comm Consolidated Health | $11.41 |
| First Health | Comm First Health | $11.41 |
| Point32Health | Comm Harvard | $11.41 |
| Other Commercial | Comm Other | $11.41 |
| PHCS | Comm PHCS | $11.41 |
| Self Pay | Comm Self Pay | $11.41 |
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