Ketorolac injection, 15 mg at WellSpan Ephrata Community Hospital. CPT J1885.
What WellSpan Ephrata Community Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$12.00cash price (self-pay)
$27.50list price
$0.30–$19.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth_Caritas_Medicaid | All_Plans | $0.30 |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $0.30 |
| Geisinger_Medicaid | All_Plans | $0.30 |
| Health_Partners_Medicaid | All_Other_Plans | $0.30 |
| Highmark_Medicare | All_Plans | $0.30 |
| Aetna_Advantra_Medicare | All_Plans | $0.31 |
| Aetna_Medicare | All_Plans | $0.31 |
| Aetna_Better_Health_Kids | All_Plans | $0.32 |
| Amerihealth_Medicare | All_Plans | $0.32 |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $0.32 |
| Geisinger_Gold_Medicare | All_Plans | $0.32 |
| Jefferson_Health_Medicare_Advantage | All_Plans | $0.32 |
| PA_Health_&_Wellness_Medicare | All_Plans | $0.32 |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $0.32 |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $0.32 |
| WellSpan_Capital_Blue_Cross | All_Plans | $0.36 |
| UPMC_Medicaid | All_Plans | $0.36 |
| Highmark | Higmark_Healthy_Kids | $0.47 |
| Health_Partners_Medicaid | Kidz_Partners | $0.49 |
| United_Medicaid | Community_Plan_For_Kids | $0.53 |
| Aetna | All_Plans | $0.92 |
| First_Health_Network | All_Plans | $1.01 |
| Highmark | My_Direct_Blue | $1.10 |
| Highmark | My_Priority_Blue_Flex | $1.10 |
| United_Healthcare | All_Plans | $1.12 |
| Highmark | Choice_Blue_PPO | $1.14 |
| Highmark | Performance_Blue | $1.14 |
| Highmark | Blue_Cross_High_Performance_Network | $1.14 |
| Highmark | All_Other_Plans | $1.38 |
| Cigna | All_Plans | $1.75 |
Inpatient
$12.00cash price (self-pay)
$27.50list price
$9.57–$27.60range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | All_Plans | $17.55 |
| Independence_Blue_Cross | All_Plans | $17.88 |
| Tower Health | All_Plans | $18.84 |
| PHC | All_Plans | $19.52 |
| UPMC | Employees_And_Dependents | $22.00 |
| UPMC | UPMC_For_Kids | $22.00 |
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