Ketorolac injection, 15 mg at Legacy Good Samaritan Medical Center IP Rehab. CPT J1885.
What Legacy Good Samaritan Medical Center IP Rehab publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2.60cash price (self-pay)
$7.67list price
$0.34–$1.32range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Medicare Managed Care Plan | $0.34 |
| Atrio | Medicare Managed Care Plan | $0.35 |
| Aetna | Medicare Managed Care Plan | $0.36 |
| HealthNet | Medicare Managed Care Plan | $0.36 |
| CareOregon | Medicare Managed Care Plan | $0.37 |
| Ageright | Medicare Managed Care Plan | $0.38 |
| Moda | Medicare Managed Care Plan | $0.38 |
| PacificSource | Navigator All Commercial Plans | $0.48 |
| PacificSource | Voyager All Commercial Plans | $0.55 |
| Kaiser | PEBB Other Commercial Plan | $0.68 |
| Aetna | All Commercial Plans | $0.72 |
| UnitedHealthCare | All Commercial Plans | $1.13 |
| Moda | All Commercial Plans | $1.32 |
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All common services at Legacy Good Samaritan Medical Center IP Rehab