Ketorolac injection, 15 mg at Mercy Hospital Perry. CPT J1885.
What Mercy Hospital Perry publishes for this service, straight from its standard-charges file, last updated March 12, 2026.
Outpatient / ER
$2.74cash price (self-pay)
$11.00list price
$0.63–$23.21range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid [20240] | Hb Wash Jefn Linc Samc Pcmh Stod IL Medicaid | $1.65 |
| Medicaid [20240] | Hb Pcmh Mo Medicaid | $2.20 |
| Medicaid Pending [20241] | Hb Pcmh Home State Managed Medicaid | $2.20 |
| Medicaid Pending [20241] | Hb Pcmh Missouri Care Health Plan/Healthy B | $2.20 |
| BCBS Medicaid Contracted [320046] | Hb Pcmh Missouri Care Health Plan/ | $2.20 |
| Humana Medicare Advantage [20194] | Hb Pcmh Medicare/Managed Mcr W/Seq | $3.35 |
| Medicare [20244] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1% | $3.35 |
| BCBS Medicare Advantage [20047] | Hb Pcmh Medicare/Managed Mcr W/Seq 9 | $3.35 |
| Cross Timbers Hospice [20098] | Hb Pcmh Medicare/Managed Mcr W/Seq 98. | $3.35 |
| Blue Cross And Blue Shield [20053] | Hb Pcmh Medicare/Managed Mcr W/Se | $3.35 |
| Elara Caring Aspire Hospice [20433] | Hb Pcmh Medicare/Managed Mcr W/S | $3.35 |
| Halo Hcr Inc Hospice [20432] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1 | $3.35 |
| Mercy Hospice Okc [20252] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1% | $3.35 |
| Kindful Hospice [20434] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1% | $3.35 |
| BCBS Medicare Advantage Contracted [320047] | Hb Pcmh Medicare/Managed | $3.35 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Pcmh Medicare/Man | $3.35 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Pcmh Medicare/Managed | $3.35 |
| Aetna Medicare Advantage Contracted [320010] | Hb Pcmh Aetna/Coventry | $3.48 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Pcmh UHC Va 100% Mcr | $3.96 |
| Ambetter [20452] | Hb Pcmh Ambetter Exchange | $5.21 |
| Blue Cross And Blue Shield [20053] | Hb Stlo Wash Jefn Linc Samc Cape | $5.23 |
| Blue Cross And Blue Shield [20053] | Hb Pcmh Anthem Blue Preferred | $6.82 |
| Blue Cross And Blue Shield [20053] | Hb Pcmh Anthem Pathway/Exchange | $6.82 |
| First Health [20128] | Hb Pcmh Linc Aetna Coventry All Products | $7.21 |
| Aetna [20008] | Hb Pcmh Linc Aetna Coventry All Products | $7.21 |
| Aetna Contracted [320008] | Hb Pcmh Linc Aetna Coventry All Products | $7.21 |
| Blue Cross And Blue Shield [20053] | Hb Pcmh Anthem Blue Access | $7.70 |
| Mc Anthem [20455] | Hb Pcmh Anthem Blue Access | $7.70 |
| Mc Generic Anthem [20456] | Hb Pcmh Anthem Blue Access | $7.70 |
| Cigna Healthcare Contracted [320071] | Hb Pcmh Cigna | $8.20 |
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