Ketorolac injection, 15 mg at Saint Alphonsus Medical Center-Ontario. CPT J1885.
What Saint Alphonsus Medical Center-Ontario publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$1.00cash price (self-pay)
$5.53list price
$0.30–$36.62range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Id | Medicaid | $0.55 |
| Medicaid - Ne | Medicaid | $0.90 |
| Medicaid - IL | Medicaid | $1.21 |
| Chhuny | Medicaid | $1.66 |
| Blue Cross - NY (Excellus) Medicaid Advantage | Medicaid | $1.66 |
| Cigna Medicaid Advantage | Medicaid | $1.66 |
| Meridian Medicaid | Medicaid | $1.66 |
| Medicaid - Ia | Medicaid | $1.66 |
| Commonwealth Care Alliance Medicaid | Medicaid | $1.66 |
| Illinicare Health Medicaid Advantage | Medicaid | $1.66 |
| California Health And Wellness | Medicaid | $1.66 |
| Medicaid - Nv | Medicaid | $1.66 |
| Huron Valley Pace Medicaid | Medicaid | $1.66 |
| Health New England Medicaid Advantage | Medicaid | $1.66 |
| Geisinger Medicaid Advantage | Medicaid | $1.66 |
| Caresource Medicaid | Medicaid | $1.66 |
| Paramount Advantage | Medicaid | $1.66 |
| Tenncare | Medicaid | $1.66 |
| Blue Cross - Tn Medicaid Advantage | Medicaid | $1.66 |
| Care Oregon Ohp | Medicaid | $1.66 |
| Total Health Care Medicaid | Medicaid | $1.66 |
| Id County Ada | Medicaid County | $1.66 |
| Paramount Medicaid Advantage | Medicaid | $1.66 |
| Medicaid - Ks | Medicaid | $1.66 |
| Upper Peninsula Health Plan (Uphp) Medicaid | Medicaid | $1.66 |
| Medicaid - Co | Medicaid | $1.66 |
| Medicaid - Ar | Medicaid | $1.66 |
| Superior Health | Medicaid | $1.66 |
| Medicaid - Ct | Medicaid | $1.66 |
| Humana | Humana | $2.64 |
Inpatient
$10.45cash price (self-pay)
$10.45list price
$0.30–$1.21range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Or | Medicaid | $0.30 |
| Oregon Screenwise | Oregon Screenwise | $0.30 |
| Medicaid - Ne | Medicaid | $0.30 |
| Moda Health | Moda | $0.31 |
| United Healthcare Medicare | UHC Medicare Advantage | $0.33 |
| Medicaid - Mi | Medicaid | $0.33 |
| Pacificsource Health Plans | Pacificsource Smart Alliance | $0.35 |
| Humana | Humana | $0.41 |
| Moda Health | Moda Health Select | $0.42 |
| Mountain Health Co-Op | Mountain Health Co-Op | $0.42 |
| Selecthealth | Select Health | $0.42 |
| Selecthealth | Select Health Med Network | $0.47 |
| Pacificsource Health Plans | Pacificsource | $0.49 |
| Cigna | Cigna | $0.54 |
| Healthcare Management Admin | Regence Bs Id PPO\Ppp | $0.59 |
| Asuris Northwest Health | Regence Bs Id PPO\Ppp | $0.59 |
| Blue Shield - Id (Regence) | Regence Bs Id PPO\Ppp | $0.59 |
| Medicaid - Id | Medicaid | $0.65 |
| Geha | United Healthcare | $0.75 |
| United Healthcare | United Healthcare | $0.75 |
| Medicaid - IL | Medicaid | $1.21 |
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All common services at Saint Alphonsus Medical Center-Ontario