Ketorolac injection, 15 mg at HSHS St. Mary's Hospital Medical Center. CPT J1885.

What HSHS St. Mary's Hospital Medical Center publishes for this service, straight from its standard-charges file, last updated March 24, 2026.

Outpatient / ER

$8.09cash price (self-pay)

$24.50list price

$0.33–$49.00range insurers pay

Insurance plan	Negotiated rate
Aetna \| Aetna Medicare	$0.33
Anthem \| Anthem Medicare Advantage HMO	$0.33
Humana \| Humana Medicare Advantage	$0.33
Medicare Managed \| Managed Medicare No Sequestration	$0.33
Molina Healthcare \| Molina Medicare	$0.33
Security Health Plan \| Medicare Advantage Security Health Plan Of Wi	$0.33
United Healthcare \| United Health Care Medicare	$0.33
United Healthcare \| All Commercial United Healthcare	$0.54
United Healthcare \| UHC Oneida Nation	$0.54
Anthem \| Anthem POS/HMO	$0.56
P360 Small Group \| Prevea 360 Small Group Commercial Plan	$0.59
Prevea Health Network \| Prevea Employees	$0.59
Prevea Health Network \| Prevea360	$0.59
Prevea Health Network \| Prevea360 - Network	$0.59
Anthem \| Anthem PPO	$0.69
Naphcare \| All Commerical Naphcare	$0.75
Humana \| Humana Choice Care HMO	$1.41
Humana \| Humana Natiional POS HMO	$1.41
Hshs Employees \| Hshs Employees	$11.91
Molina Healthcare Of Wi \| All Commerical Molina Marketplace	$12.25
Security Health Plan \| All Commercial Security Health Plan Broad Netwo	$15.64
Cigna \| All Commercial Cigna	$17.15
Health Eos \| All Commercial Health Eos	$17.40
Triology \| All Commercial Triology	$17.64
Healthsmart \| All Commercial Healthsmart	$17.89
Interplan \| All Commercial Interplan Health Group	$17.89
Network Health Plan \| All Commerical Network Health Plan	$18.38
Health Care Alliance \| The Alliance	$20.58
Multiplan/Phcs \| All Commercial Multiplan	$20.58
Choicecare \| All Commercial Choice Care	$20.83

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