Ketorolac injection, 15 mg at Intermountain Health Logan Regional Hospital. CPT J1885.
What Intermountain Health Logan Regional Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3.10cash price (self-pay)
$12.94list price
$0.33–$24.62range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Plan of Nevada | Medicaid | $2.70 |
| SelectHealth | Medicaid | $2.70 |
| Donor Connect | Other | $3.44 |
| Intermountain Caregiver Plan | Med Network | $3.82 |
| Intermountain Caregiver Plan | Share Network | $3.82 |
| EMI | Commercial | $8.98 |
| Deseret Mutual | All Other | $9.00 |
| Deseret Mutual | Select | $9.00 |
| Campbell Scientific | Commercial | $9.06 |
| Franklin County | Commercial | $9.06 |
| Juniper Systems | Commercial | $9.06 |
| LW Miller | Commercial | $9.06 |
| CorVel Corporation | Workers Comp | $9.71 |
| Corporation of the President | Workers Comp | $9.71 |
| Injury Care of Nevada | Workers Comp | $9.71 |
| AWH Connected | Connected Utah | $10.07 |
| PEHP | Advantage Non-State | $10.35 |
| PEHP | Advantage State | $10.35 |
| PEHP | Capital Care | $10.35 |
| EMI Health | Mint | $10.39 |
| EMI Health | Network Care | $10.39 |
| Managed Care Admin | Commercial | $10.39 |
| AG Administrators | USU Athletics | $11.00 |
| Altius MHNet Behavioral Health | Behavioral Health | $11.00 |
| BYU Athletics | Commercial | $11.00 |
| BYU Risk Management | Workers Comp | $11.00 |
| Cigna | Open Access Flex | $11.00 |
| Global Excel | Commercial | $11.00 |
| MedCare International | Commercial | $11.00 |
| Aetna | Standard | $12.29 |
Inpatient
$3.10cash price (self-pay)
$12.94list price
$0.09–$24.37range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $0.27 |
| Health Plan of Nevada | Medicaid | $3.88 |
| Intermountain Caregiver Plan | Med Network | $5.49 |
| Intermountain Caregiver Plan | Share Network | $5.49 |
| Campbell Scientific | Commercial | $9.06 |
| Franklin County | Commercial | $9.06 |
| Juniper Systems | Commercial | $9.06 |
| LW Miller | Commercial | $9.06 |
| CorVel Corporation | Workers Comp | $9.71 |
| Corporation of the President | Workers Comp | $9.71 |
| Injury Care of Nevada | Workers Comp | $9.71 |
| AG Administrators | USU Athletics | $11.00 |
| Altius MHNet Behavioral Health | Behavioral Health | $11.00 |
| BYU Athletics | Commercial | $11.00 |
| BYU Risk Management | Workers Comp | $11.00 |
| Cigna | Open Access Flex | $11.00 |
| Global Excel | Commercial | $11.00 |
| MedCare International | Commercial | $11.00 |
| AWH Connected | Connected Utah | $11.04 |
| Deseret Mutual | All Other | $11.04 |
| Deseret Mutual | Select | $11.04 |
| EMI Health | Mint | $11.04 |
| EMI Health | Network Care | $11.04 |
| EMI | Commercial | $11.04 |
| Managed Care Admin | Commercial | $11.04 |
| PEHP | Advantage Non-State | $11.04 |
| PEHP | Advantage State | $11.04 |
| PEHP | Capital Care | $11.04 |
| Aetna | Connected | $12.29 |
| Aetna | Extended | $12.29 |
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All common services at Intermountain Health Logan Regional Hospital