Ketorolac injection, 15 mg at Intermountain Health LDS Hospital. CPT J1885.
What Intermountain Health LDS Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$4.14cash price (self-pay)
$5.52list price
$0.33–$47.19range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SelectHealth | Signature Individual ACA | $1.02 |
| SelectHealth | Value Individual ACA | $1.02 |
| SelectHealth | Med Individual ACA | $1.11 |
| Donor Connect | Other | $1.43 |
| Health Plan of Nevada | Medicaid | $1.66 |
| SelectHealth | Medicaid | $1.66 |
| Intermountain Caregiver Plan | Share Network | $2.34 |
| SelectHealth | FEHBP | $2.34 |
| SelectHealth | SelectShare | $2.34 |
| SelectHealth | SelectValue | $2.34 |
| Intermountain Caregiver Plan | Med Network | $2.66 |
| SelectHealth | CHP | $2.66 |
| SelectHealth | Commercial | $2.66 |
| SelectHealth | SelectCare | $2.79 |
| EMI | Commercial | $2.98 |
| Deseret Mutual | All Other | $3.17 |
| Deseret Mutual | Select | $3.20 |
| Cigna | Open Access Flex | $3.48 |
| AWH Connected | Connected Utah | $3.56 |
| EMI Health | Mint | $3.83 |
| EMI Health | Network Care | $3.83 |
| AG Administrators | USU Athletics | $3.97 |
| BYU Athletics | Commercial | $3.97 |
| Campbell Scientific | Commercial | $3.97 |
| CorVel Corporation | Workers Comp | $3.97 |
| Franklin County | Commercial | $3.97 |
| Juniper Systems | Commercial | $3.97 |
| LW Miller | Commercial | $3.97 |
| BYU Risk Management | Workers Comp | $4.03 |
| Corporation of the President | Workers Comp | $4.03 |
Inpatient
$4.14cash price (self-pay)
$5.52list price
$0.07–$47.19range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $0.07 |
| Health Plan of Nevada | Medicaid | $1.66 |
| Intermountain Caregiver Plan | Share Network | $2.34 |
| Intermountain Caregiver Plan | Med Network | $2.66 |
| EMI | Commercial | $2.98 |
| Deseret Mutual | All Other | $3.17 |
| Deseret Mutual | Select | $3.20 |
| Regence BCBS | BlueOption | $3.41 |
| Cigna | Open Access Flex | $3.48 |
| AWH Connected | Connected Utah | $3.51 |
| EMI Health | Mint | $3.83 |
| EMI Health | Network Care | $3.83 |
| PEHP | Advantage State | $3.84 |
| BYU Risk Management | Workers Comp | $3.86 |
| Corporation of the President | Workers Comp | $3.86 |
| Regence BCBS | High Performance | $3.86 |
| Regence BCBS | FEHBP | $3.89 |
| PEHP | Advantage Non-State | $3.92 |
| AG Administrators | USU Athletics | $3.97 |
| BYU Athletics | Commercial | $3.97 |
| Campbell Scientific | Commercial | $3.97 |
| CorVel Corporation | Workers Comp | $3.97 |
| Franklin County | Commercial | $3.97 |
| Juniper Systems | Commercial | $3.97 |
| LW Miller | Commercial | $3.97 |
| Managed Care Admin | Commercial | $3.97 |
| Injury Care of Nevada | Workers Comp | $4.14 |
| Regence BCBS | Traditional | $4.20 |
| Aetna | Connected | $4.42 |
| Molina | CHIP | $4.53 |
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