Ketorolac injection, 15 mg at Intermountain Health Spanish Fork Hospital. CPT J1885.
What Intermountain Health Spanish Fork Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3.15cash price (self-pay)
$13.35list price
$0.33–$20.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SelectHealth | Signature Individual ACA | $1.11 |
| SelectHealth | Value Individual ACA | $1.11 |
| SelectHealth | Med Individual ACA | $1.25 |
| Health Plan of Nevada | Medicaid | $1.26 |
| SelectHealth | Medicaid | $1.26 |
| Intermountain Caregiver Plan | Share Network | $1.78 |
| SelectHealth | FEHBP | $1.78 |
| SelectHealth | SelectShare | $1.78 |
| SelectHealth | SelectValue | $1.78 |
| Intermountain Caregiver Plan | CHP | $2.02 |
| Intermountain Caregiver Plan | Med Network | $2.02 |
| SelectHealth | SelectMed/CHIP | $2.02 |
| SelectHealth | SelectCare | $2.13 |
| Donor Connect | Other | $3.60 |
| EMI | Commercial | $7.21 |
| Deseret Mutual | Commercial | $7.68 |
| Deseret Mutual | Connected Utah | $7.68 |
| Cigna | Open Access Flex | $8.41 |
| AWH Connected | Connected Utah | $8.61 |
| EMI Health | Mint | $9.26 |
| EMI Health | Network Care | $9.26 |
| PEHP | Advantage Non-State | $9.48 |
| BYU Athletics | Commercial | $9.61 |
| Campbell Scientific | Commercial | $9.61 |
| CorVel Corporation | Workers Comp | $9.61 |
| Franklin County | Commercial | $9.61 |
| Juniper Systems | Commercial | $9.61 |
| LW Miller | Commercial | $9.61 |
| BYU Risk Management | Workers Comp | $9.75 |
| Corporation of the President | Workers Comp | $9.75 |
Inpatient
$3.15cash price (self-pay)
$13.35list price
$0.27–$20.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $0.86 |
| SelectHealth | Med Individual ACA | $3.98 |
| Health Plan of Nevada | Medicaid | $4.00 |
| Intermountain Caregiver Plan | Share Network | $5.66 |
| SelectHealth | FEHBP | $5.66 |
| Intermountain Caregiver Plan | CHP | $6.43 |
| Intermountain Caregiver Plan | Med Network | $6.43 |
| EMI | Commercial | $7.21 |
| Deseret Mutual | Commercial | $7.68 |
| Deseret Mutual | Connected Utah | $7.68 |
| Regence BCBS | BlueOption | $8.24 |
| Cigna | Open Access Flex | $8.41 |
| AWH Connected | Connected Utah | $8.48 |
| EMI Health | Mint | $9.26 |
| EMI Health | Network Care | $9.26 |
| PEHP | Advantage State | $9.29 |
| BYU Risk Management | Workers Comp | $9.35 |
| Corporation of the President | Workers Comp | $9.35 |
| Regence BCBS | High Performance | $9.35 |
| Regence BCBS | FEHBP | $9.41 |
| PEHP | Advantage Non-State | $9.48 |
| BYU Athletics | Commercial | $9.61 |
| Campbell Scientific | Commercial | $9.61 |
| CorVel Corporation | Workers Comp | $9.61 |
| Franklin County | Commercial | $9.61 |
| Juniper Systems | Commercial | $9.61 |
| LW Miller | Commercial | $9.61 |
| Injury Care of Nevada | Workers Comp | $10.01 |
| Regence BCBS | Traditional | $10.15 |
| Managed Care Admin | Commercial | $10.42 |
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All common services at Intermountain Health Spanish Fork Hospital