Ketorolac injection, 15 mg at Intermountain Health Orem Community Hospital. CPT J1885.
What Intermountain Health Orem Community Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3.15cash price (self-pay)
$5.49list price
$0.33–$32.49range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SelectHealth | Signature Individual ACA | $1.11 |
| SelectHealth | Value Individual ACA | $1.11 |
| SelectHealth | Med Individual ACA | $1.26 |
| Health Plan of Nevada | Medicaid | $1.27 |
| SelectHealth | Medicaid | $1.27 |
| Donor Connect | Other | $1.53 |
| 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 | Commercial | $2.63 |
| SelectHealth | SelectCare | $2.76 |
| EMI | Commercial | $2.96 |
| Deseret Mutual | All Other | $3.16 |
| Deseret Mutual | Select | $3.16 |
| Cigna | Open Access Flex | $3.46 |
| AWH Connected | Connected Utah | $3.54 |
| EMI Health | Mint | $3.81 |
| EMI Health | Network Care | $3.81 |
| AG Administrators | USU Athletics | $3.95 |
| BYU Athletics | Commercial | $3.95 |
| Campbell Scientific | Commercial | $3.95 |
| CorVel Corporation | Workers Comp | $3.95 |
| Franklin County | Commercial | $3.95 |
| Juniper Systems | Commercial | $3.95 |
| LW Miller | Commercial | $3.95 |
| BYU Risk Management | Workers Comp | $4.01 |
| Corporation of the President | Workers Comp | $4.01 |
Inpatient
$3.15cash price (self-pay)
$5.49list price
$0.10–$32.49range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $0.13 |
| Health Plan of Nevada | Medicaid | $1.65 |
| Intermountain Caregiver Plan | Share Network | $2.33 |
| Intermountain Caregiver Plan | Med Network | $2.65 |
| SelectHealth | CHP | $2.65 |
| SelectHealth | Commercial | $2.65 |
| EMI | Commercial | $2.96 |
| Deseret Mutual | All Other | $3.16 |
| Deseret Mutual | Select | $3.16 |
| Regence BCBS | BlueOption | $3.39 |
| Cigna | Open Access Flex | $3.46 |
| AWH Connected | Connected Utah | $3.49 |
| EMI Health | Mint | $3.81 |
| EMI Health | Network Care | $3.81 |
| PEHP | Advantage State | $3.82 |
| BYU Risk Management | Workers Comp | $3.84 |
| Corporation of the President | Workers Comp | $3.84 |
| Regence BCBS | High Performance | $3.84 |
| Regence BCBS | FEHBP | $3.87 |
| PEHP | Advantage Non-State | $3.90 |
| AG Administrators | USU Athletics | $3.95 |
| BYU Athletics | Commercial | $3.95 |
| Campbell Scientific | Commercial | $3.95 |
| CorVel Corporation | Workers Comp | $3.95 |
| Franklin County | Commercial | $3.95 |
| Juniper Systems | Commercial | $3.95 |
| LW Miller | Commercial | $3.95 |
| Injury Care of Nevada | Workers Comp | $4.12 |
| Regence BCBS | Traditional | $4.18 |
| Managed Care Admin | Commercial | $4.29 |
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All common services at Intermountain Health Orem Community Hospital