Ketorolac injection, 15 mg at Dallam Hartley Counties Hospital District. CPT J1885.
What Dallam Hartley Counties Hospital District publishes for this service, straight from its standard-charges file, last updated May 4, 2026.
Outpatient / ER
$10.50cash price (self-pay)
$15.00list price
$0.15–$25.54range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Blue Advantage | PPO | $0.15 |
| BCBS Blue Essentials HMO | HMO | $0.17 |
| BCBS Blue Traditional/PPO | PPO | $0.19 |
| Baylor Scott and White Medicare Advantage | HMO | $0.34 |
| Provider Network of America | PPO | $0.51 |
| Cigna Commercial | PPO | $10.20 |
| United Healthcare Commercial | PPO | $11.70 |
| Baylor Scott and White Medicaid Replacement | HMO | $14.19 |
Inpatient
$10.50cash price (self-pay)
$15.00list price
$1.00–$19.71range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Commercial | PPO | $1.00 |
| BCBS Blue Advantage | PPO | $8.40 |
| BCBS Blue Essentials HMO | HMO | $9.45 |
| BCBS Blue Traditional/PPO | PPO | $10.50 |
| Cigna Commercial | PPO | $10.95 |
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All common services at Dallam Hartley Counties Hospital District