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Ketorolac injection, 15 mg at WellSpan Surgery & Rehabilitation Hospital. CPT J1885.

What WellSpan Surgery & Rehabilitation Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.

Outpatient / ER

$26.80cash price (self-pay)
$33.50list price
$0.30–$32.50range insurers pay
Insurance planNegotiated rate
Amerihealth_Caritas_Medicaid | All_Plans$0.30
Blue_Cross_BlueJourney_Medicare | All_Plans$0.30
Geisinger_Medicaid | All_Plans$0.30
Health_Partners_Medicaid | All_Other_Plans$0.30
Highmark_Medicare | All_Plans$0.30
Johns_Hopkins_HealthCare_Plan | Johns_Hopkins_US_Family_Health$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
Devoted_Medicare | All_Plans$0.32
United_Medicare | ISNP_DSNP_Plans$0.32
WellSpan_Capital_Blue_Cross | All_Plans$0.36
UPMC_Medicare | UPMC_for_Life_Community_HealthChoices$0.36
UPMC_Medicare | UPMC_for_Life_Complete_Care$0.36
UPMC_Medicaid | All_Plans$0.36
Highmark | Higmark_Healthy_Kids$0.46
Health_Partners_Medicaid | Kidz_Partners$0.50
United_Medicaid | Community_Plan_For_Kids$0.53
Aetna | All_Plans$0.92
First_Health_Network | All_Plans$0.92
United_Healthcare | All_Plans$1.12
Highmark | Choice_Blue_PPO$1.17
Highmark | Performance_Blue$1.17
Highmark | Blue_Cross_High_Performance_Network$1.17
Highmark | All_Other_Plans$1.49

Inpatient

$26.80cash price (self-pay)
$33.50list price
$19.39–$31.83range insurers pay
Insurance planNegotiated rate
Blue_Cross | Capital_Blue_Performance_PPO$19.39
Blue_Cross | Capital_Cares_4_kids$19.79
Aetna | All_Plans$29.65
First_Health_Network | All_Plans$29.65
Cigna | All_Plans$30.03
Blue_Cross | All_Other_Plans$30.03
UPMC | UPMC_For_Kids$31.16
UPMC | All_Plans$31.16
Geisinger | All_Plans$31.37
Johns_Hopkins_HealthCare_Plan | All_Other_Plans$31.83
PHC | All_Plans$31.83
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All common services at WellSpan Surgery & Rehabilitation Hospital