Ketorolac injection, 15 mg at Intermountain Health American Fork Hospital. CPT J1885.
What Intermountain Health American Fork Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$4.10cash price (self-pay)
$13.98list price
$0.25–$20.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SelectHealth | Signature Individual ACA | $1.44 |
| SelectHealth | Value Individual ACA | $1.44 |
| SelectHealth | Med Individual ACA | $1.63 |
| Intermountain Caregiver Plan | Share Network | $2.32 |
| SelectHealth | FEHBP | $2.32 |
| SelectHealth | SelectShare | $2.32 |
| SelectHealth | SelectValue | $2.32 |
| Intermountain Caregiver Plan | Med Network | $2.63 |
| SelectHealth | CHP | $2.63 |
| SelectHealth | CH{ | $2.63 |
| SelectHealth | Commercial | $2.63 |
| SelectHealth | SelectCare | $2.76 |
| Donor Connect | Other | $3.38 |
| EMI | Commercial | $7.55 |
| Deseret Mutual | All Other | $8.04 |
| Deseret Mutual | Select | $8.04 |
| Cigna | Open Access Flex | $8.81 |
| AWH Connected | Connected Utah | $9.02 |
| EMI Health | Mint | $9.70 |
| EMI Health | Network Care | $9.70 |
| PEHP | Advantage State | $9.73 |
| PEHP | Advantage Non-State | $9.93 |
| AG Administrators | USU Athletics | $10.06 |
| BYU Athletics | Commercial | $10.06 |
| Campbell Scientific | Commercial | $10.06 |
| CorVel Corporation | Workers Comp | $10.06 |
| Franklin County | Commercial | $10.06 |
| Juniper Systems | Commercial | $10.06 |
| LW Miller | Commercial | $10.06 |
| BYU Risk Management | Workers Comp | $10.21 |
Inpatient
$4.10cash price (self-pay)
$13.98list price
$0.10–$20.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $0.25 |
| Intermountain Caregiver Plan | Share Network | $5.93 |
| SelectHealth | FEHBP | $5.93 |
| Intermountain Caregiver Plan | Med Network | $6.73 |
| SelectHealth | CHP | $6.73 |
| SelectHealth | CH{ | $6.73 |
| SelectHealth | Commercial | $6.73 |
| EMI | Commercial | $7.55 |
| Deseret Mutual | All Other | $8.04 |
| Deseret Mutual | Select | $8.04 |
| Regence BCBS | BlueOption | $8.63 |
| Cigna | Open Access Flex | $8.81 |
| AWH Connected | Connected Utah | $8.88 |
| EMI Health | Mint | $9.70 |
| EMI Health | Network Care | $9.70 |
| PEHP | Advantage State | $9.73 |
| BYU Risk Management | Workers Comp | $9.79 |
| Corporation of the President | Workers Comp | $9.79 |
| Regence BCBS | High Performance | $9.79 |
| Regence BCBS | FEHBP | $9.86 |
| PEHP | Advantage Non-State | $9.93 |
| AG Administrators | USU Athletics | $10.06 |
| BYU Athletics | Commercial | $10.06 |
| Campbell Scientific | Commercial | $10.06 |
| CorVel Corporation | Workers Comp | $10.06 |
| Franklin County | Commercial | $10.06 |
| Juniper Systems | Commercial | $10.06 |
| LW Miller | Commercial | $10.06 |
| Injury Care of Nevada | Workers Comp | $10.49 |
| Regence BCBS | Traditional | $10.62 |
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All common services at Intermountain Health American Fork Hospital