Ketorolac injection, 15 mg at St. Charles Prineville. CPT J1885.
What St. Charles Prineville publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$71.70cash price (self-pay)
$89.62list price
$0.16–$89.62range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MODA MEDICAID [528] | Eastern Oregon CCO | $0.16 |
| CASCADE HEALTH ALLIANCE [532] | Oregon Medicaid CCO | $0.16 |
| OREGON MEDICAID [500] | Oregon Medicaid | $0.16 |
| YAMHILL COUNTY COORDINATED CARE ORG [550] | Oregon Medicaid CCO | $0.16 |
| INTERCOMMUNITY HEALTH [530] | Oregon Medicaid CCO | $0.16 |
| JACKSON CARE CONNECT [542] | Oregon Medicaid CCO | $0.16 |
| COLUMBIA PACIFIC COORDINATED CARE LLC [539] | Oregon Medicaid CCO | $0.16 |
| HEALTH SHARE OHSU OHP [552] | Oregon Medicaid CCO | $0.16 |
| KAISER PERMANENTE [334] | OEBB PEBB Non-Contracted | $0.62 |
| PROVIDENCE HEALTH PLAN [347] | Providence Health Plan PEBB OEBB | $0.67 |
| MODA [310] | Moda OEBB PEBB | $0.67 |
| UNITED HEALTHCARE [338] | United Healthcare | $1.08 |
| UNICARE [133] | Medicare | $25.09 |
| CHAMP VA [700] | Veteran Affairs | $25.09 |
| DEVOTED HEALTH INC [145] | Medicare | $25.09 |
| SAMARITAN HEALTH PLAN MED ADV [141] | Medicare | $25.09 |
| HUMANA MEDICARE [130] | Medicare | $25.09 |
| KAISER PERMANENTE MED ADV [136] | Medicare | $25.09 |
| ATRIO HEALTH MEDICARE [138] | Medicare | $25.09 |
| UHC MEDICARE ADVANTAGE [127] | Medicare | $25.09 |
| MEDICARE [100] | Medicare | $25.09 |
| PACIFICSOURCE [345] | PacificSource Voyager | $35.85 |
| MODA [310] | Moda Affinity | $77.07 |
| AETNA [321] | Aetna | $77.97 |
| MERITAIN HEALTH [300] | Aetna | $77.97 |
| PROVIDENCE HEALTH PLAN [347] | Providence Health Plan | $78.42 |
| AUTO TRAVELERS INSURANCE [615] | Auto Insurance | $89.62 |
| AUTO HARTFORD [612] | Auto Insurance | $89.62 |
| AUTO MUTUAL OF ENUMCLAW [610] | Auto Insurance | $89.62 |
| GENERIC AUTO [649] | Auto Insurance | $89.62 |
Inpatient
$71.70cash price (self-pay)
$89.62list price
—range insurers pay
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