Ketorolac injection, 15 mg at Le Bonheur Children's Hospital. CPT J1885.
What Le Bonheur Children's Hospital publishes for this service, straight from its standard-charges file, last updated March 19, 2026.
Outpatient / ER
$0.62cash price (self-pay)
$4.14list price
$0.30–$9.74range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Alt BCBS MS Medicare [450116] | HB MEDICARE ADVANTAGE / MANAGED CARE - | $0.30 |
| Shared Health Of Ms - Medicare Advantage [450074] | Hb Medicare Advant | $0.30 |
| Healthy Mississippi - Medicare Advantage HMO [450114] | Hb Medicare Ad | $0.30 |
| Alt BCBS TN Medicare [450115] | HB MEDICARE ADVANTAGE / MANAGED CARE - | $0.30 |
| American Health Advantage MCR ADV [450117] | HB MEDICARE ADVANTAGE / M | $0.30 |
| BCBS Medicare Advantage [450110] | Hb Medicare Advantage / Managed Car | $0.30 |
| Humana Medicare Advantage [450013] | Hb Medicare Advantage / Managed C | $0.30 |
| Optum Medicare Advantage [450112] | Hb Medicare Advantage / Managed CA | $0.30 |
| Carecentrix [450200] | Hb Medicare Advantage / Managed Care - Tn Contr | $0.30 |
| Medipak Advantage - BCBS Ar [450040] | Hb Medicare Advantage / Managed | $0.30 |
| Transplant Humana Medicare [450093] | Hb Medicare Advantage / Managed | $0.30 |
| Medicare [400001] | Hb Medicare-Tn Contract | $0.30 |
| United Healthcare Medicare [450021] | Hb Medicare Advantage / Managed | $0.30 |
| Transplant Optum Medicare [450095] | Hb Medicare Advantage / Managed C | $0.30 |
| Wellcare Medicare [450023] | Hb Medicare Advantage Wellcare/Wellpoint | $0.30 |
| Healthsprings Medicare Advantage [450007] | Hb Medicare Advantage / MA | $0.30 |
| Medicare Priority Health [450072] | Hb Medicare Advantage / Managed CA | $0.30 |
| Devoted Health [450111] | Hb Medicare Advantage Devoted - Tn Contract | $0.31 |
| CIGNA [100009] | HB CIGNA IFP - LeBonheur | $0.31 |
| CIGNA [100009] | HB CIGNA HMO - LeBonheur | $0.34 |
| CIGNA [100009] | HB CIGNA OAP – LeBonheur | $0.34 |
| CIGNA [100009] | HB CIGNA LocalPlus - LeBonheur | $0.34 |
| CIGNA [100009] | HB Cigna PPO - LeBonheur | $0.34 |
| Molina Healthcare [350012] | Hb Molina Hc Of Ms - Mscan Mlh-Tn Contrac | $0.49 |
| UHC Medicaid [350006] | Hb UHC Ms Can Mlh-Tn-Leb Contract | $0.49 |
| Molina Healthcare [350012] | Hb Molina Mschips - Mlh-Tn Contract | $0.61 |
| Alt BCBS TN Commercial [200008] | HB XR BCBS Network S LeBonheur Child | $0.77 |
| Alt BCBS MS Commercial [200009] | HB XR BCBS Network S LeBonheur Child | $0.77 |
| BCBS Commercial [200011] | HB XR BCBS Network S LeBonheur Childrens | $0.77 |
| BCBS TN [200003] | HB XR BCBS Network S LeBonheur Childrens | $0.77 |
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