Ketorolac injection, 15 mg at Frisbie Memorial Hospital. CPT J1885.
What Frisbie Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$11.00cash price (self-pay)
$26.00list price
$0.41–$66.40range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | INDEMNITY | $0.41 |
| Anthem | BlueChoice | $0.45 |
| Anthem | HPN | $0.47 |
| Humana Military | TRICR | $0.48 |
| Martin's Point Health | TRICR | $0.50 |
| Anthem | FEP | $0.52 |
| Anthem | HMO | $0.52 |
| Anthem | IndividualOffExhange | $0.52 |
| Anthem | POS | $0.52 |
| Anthem | PPO | $0.52 |
| Cigna | HMO | $0.87 |
| Cigna | PPO | $0.87 |
| AmeriHealth Caritas | MCD | $2.14 |
| Well Sense Health Plan | MCD | $3.17 |
| Harvard Pilgrim | INDIVIDUAL | $6.90 |
| Maine Community Health | Individual | $7.42 |
| Maine Community Health | SmallGroup | $7.42 |
| Harvard Pilgrim | ELEVATE | $8.36 |
| Tufts Health Plan | HMO | $8.92 |
| Tufts Health Plan | PPO | $8.92 |
| United | FreedomBenefitPlans | $8.92 |
| Harvard Pilgrim | HMO | $10.53 |
| Harvard Pilgrim | POS | $10.53 |
| Harvard Pilgrim | PPO | $10.53 |
| United | AllPayerAppendix | $10.89 |
| Maine Community Health | LargeGroup | $12.57 |
| Tufts Health Plan | POS | $14.87 |
| Aetna | EPO | $15.03 |
| Aetna | HMO | $15.03 |
| Aetna | POS | $15.03 |
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