Ketorolac injection, 15 mg at Intermountain Health Utah Valley Hospital. CPT J1885.
What Intermountain Health Utah Valley Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$4.14cash price (self-pay)
$15.01list price
$0.27–$30.78range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SelectHealth | Signature Individual ACA | $1.46 |
| SelectHealth | Value Individual ACA | $1.46 |
| SelectHealth | Med Individual ACA | $1.64 |
| Intermountain Caregiver Plan | Share Network | $3.19 |
| SelectHealth | FEHBP | $3.19 |
| SelectHealth | SelectShare | $3.19 |
| SelectHealth | SelectValue | $3.19 |
| Donor Connect | Other | $3.58 |
| Intermountain Caregiver Plan | Med Network | $3.62 |
| SelectHealth | CHP | $3.62 |
| SelectHealth | Med | $3.62 |
| SelectHealth | SelectCare | $3.81 |
| EMI | Commercial | $8.11 |
| Deseret Mutual | All Other | $8.63 |
| Deseret Mutual | Connected Utah | $8.63 |
| Cigna | Open Access Flex | $9.46 |
| AWH Connected | Connected Utah | $9.68 |
| EMI Health | Mint | $10.41 |
| EMI Health | Network Care | $10.41 |
| PEHP | Advantage Non-State | $10.66 |
| AG Administrators | USU Athletics | $10.80 |
| BYU Athletics | Commercial | $10.80 |
| Campbell Scientific | Commercial | $10.80 |
| CorVel Corporation | Workers Comp | $10.80 |
| Franklin County | Commercial | $10.80 |
| Juniper Systems | Commercial | $10.80 |
| LW Miller | Commercial | $10.80 |
| BYU Risk Management | Workers Comp | $10.96 |
| Corporation of the President | Workers Comp | $10.96 |
| Injury Care of Nevada | Workers Comp | $11.26 |
Inpatient
$4.14cash price (self-pay)
$15.01list price
$0.08–$30.78range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $0.21 |
| Health Plan of Nevada | Medicaid | $4.50 |
| Intermountain Caregiver Plan | Share Network | $6.36 |
| Intermountain Caregiver Plan | Med Network | $7.23 |
| SelectHealth | CHP | $7.23 |
| EMI | Commercial | $8.11 |
| Deseret Mutual | All Other | $8.63 |
| Deseret Mutual | Connected Utah | $8.63 |
| Regence BCBS | BlueOption | $9.27 |
| Cigna | Open Access Flex | $9.46 |
| AWH Connected | Connected Utah | $9.54 |
| EMI Health | Mint | $10.41 |
| EMI Health | Network Care | $10.41 |
| PEHP | Advantage State | $10.45 |
| BYU Risk Management | Workers Comp | $10.50 |
| Corporation of the President | Workers Comp | $10.50 |
| Regence BCBS | High Performance | $10.50 |
| Regence BCBS | FEHBP | $10.58 |
| PEHP | Advantage Non-State | $10.66 |
| AG Administrators | USU Athletics | $10.80 |
| BYU Athletics | Commercial | $10.80 |
| Campbell Scientific | Commercial | $10.80 |
| CorVel Corporation | Workers Comp | $10.80 |
| Franklin County | Commercial | $10.80 |
| Juniper Systems | Commercial | $10.80 |
| LW Miller | Commercial | $10.80 |
| Injury Care of Nevada | Workers Comp | $11.26 |
| Regence BCBS | Traditional | $11.41 |
| Managed Care Admin | Commercial | $11.71 |
| Aetna | Connected | $12.01 |
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All common services at Intermountain Health Utah Valley Hospital