Ketorolac injection, 15 mg at St. Luke's Health Memorial San Augustine. CPT J1885.

What St. Luke's Health Memorial San Augustine publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$5.85cash price (self-pay)

$97.37list price

$0.39–$868range insurers pay

Insurance plan	Negotiated rate
BCBS-TX \| Commercial\|Blue Premier	$0.39
BCBS-TX \| Commercial\|Blue Advantage HMO	$0.40
BCBS-TX \| Commercial\|HMO	$0.41
BCBS-TX \| Commercial\|PPO	$0.47
BCBS \| Medicare\|All Plans	$0.49
UNITED \| Medicare\|All Plans	$0.49
SCANHealth \| Medicare\|All Plans	$0.50
Wellpoint \| Commercial\|Exchange	$0.53
Cigna \| Commercial\|All Plans	$0.77
United \| Commercial\|Exchange	$17.53
United \| Commercial\|All Other Plans	$22.40
Aetna \| Commercial\|All Plans	$24.34
Angelina County \| Commercial\|All Plans	$38.95
Entrust \| Commercial\|All Plans	$38.95
PHCS \| Commercial\|All Plans	$66.22
Humana \| Commercial\|All Plans	$68.16
Multiplan \| Commercial\|All Plans	$68.16
Galaxy \| Commercial\|All Plans	$87.63

$5.85cash price (self-pay)

$97.37list price

$5.46–$964range insurers pay

Insurance plan	Negotiated rate
Cigna \| Commercial\|All Plans	$13.63
Aetna \| Commercial\|All Plans	$24.34
Entrust \| Commercial\|All Plans	$38.95
Humana \| Commercial\|All Plans	$68.16
Multiplan \| Commercial\|All Plans	$68.16
PHCS \| Commercial\|All Plans	$77.90
Galaxy \| Commercial\|All Plans	$87.63
United \| Commercial\|Exchange	$97.37

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