Ketorolac injection, 15 mg at Pennsylvania Hospital. CPT J1885.
What Pennsylvania Hospital publishes for this service, straight from its standard-charges file, last updated March 20, 2026.
Outpatient / ER
$3.00cash price (self-pay)
$7.00list price
$0.33–$30.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $0.33 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $0.35 |
| UPMC | UPMC Medicaid | $0.36 |
| Independence Blue Cross/Personal Choice | Personal Choice-IBC PPO | $0.39 |
| Keystone HMO Proactive | Keystone HMO Proactive | $0.39 |
| Independence Blue Cross/Keystone Health Plan East | Keystone Health Pl | $0.39 |
| Independence Blue Cross | IBC Traditional | $0.39 |
| IBC Commercial HPN | IBC Commercial HPN | $0.39 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $0.75 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $0.75 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ- HMO POS a | $0.75 |
| Horizon NJ Health | Horizon NJ Health | $1.23 |
| PA Health and Wellness Medicaid | PA Health and Wellness Medicaid | $1.26 |
| UnitedHealthcare | UnitedHealthcare Compass Exchange | $1.43 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $1.61 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $1.82 |
| US Family Health Plan | US Family Health Plan | $2.45 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $2.45 |
| Qualcare | Qualcare | $2.66 |
| UnitedHealthcare New Business | UnitedHealthcare New Business | $2.72 |
| Wissahickon Hospice | Wissahickon Hospice | $2.80 |
| Pgm - Chop | Pgm - Chop | $2.80 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $2.83 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $3.15 |
| Olympus | Olympus | $3.40 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $3.50 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $4.20 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $4.55 |
| PGM - Embassy of Qatar | PGM - Embassy of Qatar | $4.55 |
| PGM - Embassy of the United Emirates/IPC | PGM - Embassy of the United | $4.90 |
Inpatient
$3.00cash price (self-pay)
$7.00list price
$0.51–$30.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Horizon NJ Health | Horizon NJ Health | $1.18 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $1.61 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $1.82 |
| Devon | Devon Premier | $2.66 |
| Pgm - Chop | Pgm - Chop | $2.80 |
| Coventry | HealthAmerica/Coventry SEPA | $2.80 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $3.43 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $3.50 |
| First Health Global | First Health Global | $3.50 |
| Coventry | Coventry of Delaware | $3.57 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $4.20 |
| Health Net | Health Net | $4.20 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $4.55 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $4.90 |
| Preferred Care | Preferred Care | $5.60 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $5.60 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $5.60 |
| Intergroup | Intergroup | $5.60 |
| Humana Choice Care | Humana Choice Care | $5.60 |
| Health America/CCN | First Health/ Coventry National | $5.60 |
| Devon Health Services Inc | Devon Health Services | $5.60 |
| UPMC | UPMC Medicaid | $7.00 |
| United Behavioral Health | United Behavioral Health | $7.00 |
| Quest Behavioral Health | Quest Behavioral Health | $7.00 |
| Managed Medicaid Other | Managed Medicaid Other | $7.00 |
| International PFS | International PFS | $7.00 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $7.00 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $7.00 |
| Health Partners | Health Partners Medicaid | $7.00 |
| Community Behavioral Health | Community Behavioral Health | $7.00 |
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