Ketorolac injection, 15 mg at Intermountain Health Fillmore Community Hospital. CPT J1885.
What Intermountain Health Fillmore Community Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3.28cash price (self-pay)
$16.05list price
$0.59–$26.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Plan of Nevada | Medicaid | $5.43 |
| Aetna | Medicare Adv HMO | $6.57 |
| Aetna | Medicare Adv PPO | $6.57 |
| American Health | Medicare Adv UT HMO I-SNP | $6.57 |
| Health Partners of Nevada | Medicare Advantage | $6.57 |
| Humana | Medicare Choice PPO | $6.57 |
| Molina | Medicaid | $6.57 |
| Molina | Medicare Complete Care HMO SNP | $6.57 |
| Regence BCBS | MedAdvantage | $6.57 |
| Regence BCBS | MedAdvantage PPO | $6.57 |
| SelectHealth | Medicaid | $6.57 |
| SelectHealth | Medicare Advantage | $6.57 |
| UHC | Medicare Advantage | $6.57 |
| Healthy U | Medicaid | $7.38 |
| Injury Care of Nevada | Workers Comp | $12.04 |
| BYU Risk Management | Workers Comp | $13.64 |
| CorVel Corporation | Workers Comp | $13.64 |
| Corporation of the President | Workers Comp | $13.64 |
| AG Administrators | USU Athletics | $15.25 |
| Aetna | Standard | $15.25 |
| BYU Athletics | Commercial | $15.25 |
| Campbell Scientific | Commercial | $15.25 |
| Cigna | HMO | $15.25 |
| Cigna | Open Access Flex | $15.25 |
| Cigna | PPO/EPO | $15.25 |
| Deseret Mutual | All Other | $15.25 |
| Deseret Mutual | Select | $15.25 |
| EMI Health | Mint | $15.25 |
| EMI Health | Network Care | $15.25 |
| EMI | Commercial | $15.25 |
Inpatient
$3.28cash price (self-pay)
$16.05list price
$3.28–$25.73range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Injury Care of Nevada | Workers Comp | $12.04 |
| BYU Risk Management | Workers Comp | $13.64 |
| CorVel Corporation | Workers Comp | $13.64 |
| Corporation of the President | Workers Comp | $13.64 |
| Health Plan of Nevada | Medicaid | $14.29 |
| Healthy U | Medicaid | $14.29 |
| Molina | Medicaid | $14.29 |
| AG Administrators | USU Athletics | $15.25 |
| AWH Connected | Connected Utah | $15.25 |
| Aetna | Connected | $15.25 |
| Aetna | Extended | $15.25 |
| Aetna | Standard | $15.25 |
| BYU Athletics | Commercial | $15.25 |
| Campbell Scientific | Commercial | $15.25 |
| Cigna | HMO | $15.25 |
| Cigna | Open Access Flex | $15.25 |
| Cigna | PPO/EPO | $15.25 |
| Deseret Mutual | All Other | $15.25 |
| Deseret Mutual | Select | $15.25 |
| EMI Health | Mint | $15.25 |
| EMI Health | Network Care | $15.25 |
| EMI | Commercial | $15.25 |
| Franklin County | Commercial | $15.25 |
| Global Excel | Commercial | $15.25 |
| Health Utah | Commercial | $15.25 |
| Hygeia Corporation | Commercial | $15.25 |
| Intermountain Caregiver Plan | Med Network | $15.25 |
| Juniper Systems | Commercial | $15.25 |
| LW Miller | Commercial | $15.25 |
| Managed Care Admin | Commercial | $15.25 |
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All common services at Intermountain Health Fillmore Community Hospital