Ketorolac injection, 15 mg at UPMC Williamsport. CPT J1885.
What UPMC Williamsport publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$18.00cash price (self-pay)
$30.00list price
$0.29–$27.68range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $0.29 |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue | $0.29 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.30 |
| AmeriHealth Caritas | Medicare | $0.30 |
| Geisinger | Medicaid/CHIP | $0.30 |
| Highmark Wholecare (prev Gateway) | Medicaid | $0.30 |
| PA Health & Wellness | PA Medicaid HMO | $0.30 |
| Aetna | Medicare | $0.30 |
| UPMC Health Plan | Managed Medicare | $0.30 |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advant | $0.31 |
| United Healthcare | Medicare | $0.31 |
| Highmark Wholecare (prev Gateway) | Medicare | $0.31 |
| UPMC Health Plan | CHIP | $0.33 |
| UPMC Health Plan | Managed Medicaid | $0.33 |
| UPMC Work Partners | Workers Comp | $8.14 |
| Multiplan | Worker's Compensation | $8.99 |
| Highmark BCBS of PA | Managed Care - Social Mission | $11.94 |
| Aetna | PEBTF Custom Network | $12.16 |
| UPMC Health Plan | Commercial | $13.08 |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $14.06 |
| Aetna | Commercial | $14.31 |
| Coventry/First Health | Commercial | $15.03 |
| Wirerope Works | Commercial | $16.68 |
| Aetna | First Health | $19.80 |
| Geisinger | Commercial | $20.10 |
| Coventry/First Health | FH-Medical Rental | $20.19 |
| United Healthcare | Commercial | $20.52 |
| Cigna | Commercial | $20.55 |
| Multiplan | Auto | $23.40 |
| Multiplan | PPO (Includes PHCS as a Payer) | $23.40 |
Inpatient
$18.00cash price (self-pay)
$30.00list price
$8.66–$27.68range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC Work Partners | Workers Comp | $8.66 |
| Multiplan | Worker's Compensation | $9.57 |
| Aetna | PEBTF Custom Network | $12.85 |
| Aetna | Commercial | $15.12 |
| Coventry/First Health | Commercial | $15.87 |
| Wirerope Works | Commercial | $16.68 |
| Aetna | First Health | $19.80 |
| Coventry/First Health | FH-Medical Rental | $20.19 |
| United Healthcare | Commercial | $20.52 |
| Cigna | Commercial | $20.55 |
| Multiplan | Auto | $23.40 |
| Multiplan | PPO (Includes PHCS as a Payer) | $23.40 |
| America's Choice | PPO | $24.00 |
| InterGroup | PPO | $24.00 |
| Three Rivers Provider Network | All | $27.00 |
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