Ketorolac injection, 15 mg at St. Mary Medical Center. CPT J1885.
What St. Mary Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$11.30cash price (self-pay)
$24.15list price
$0.47–$50.16range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Keystone First | Keystone Medicaid | $0.93 |
| Keystone First Chip | Keystone Medicaid | $0.93 |
| Keystone First Chc Medicaid | Keystone Medicaid | $0.93 |
| Pace-Trinity Health | Trinity Health Pace | $3.14 |
| Aetna Medicaid | Aetna Better Health Medicaid | $8.45 |
| United Healthcare | United Healthcare Options | $11.69 |
| Geha | United Healthcare | $12.24 |
| United Healthcare | United Healthcare | $12.24 |
| Meritain | Aetna | $21.49 |
| Aetna | Aetna | $21.49 |
| Prime Health Services | Prime Health Services | $21.74 |
| Multiplan | Multiplan | $21.74 |
| Blue Cross - Mn | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Ia (Wellmark) | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - IL | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Wi (Anthem) | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - IL Alternate | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Mi | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Ne | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Mo (Anthem) | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Ar | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - CA (Anthem) | Independence Blue Cross HMO/PPO | $21.78 |
| Amerihealth | Independence Blue Cross HMO/PPO | $21.78 |
| BCBS Generic | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Va (Carefirst) | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Wa (Premera) | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Shield - Wa (Regence) | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Federal | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - TX | Independence Blue Cross HMO/PPO | $21.78 |
| Blue Cross - Ut (Regence) | Independence Blue Cross HMO/PPO | $21.78 |
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