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Phenylephrine and Ketorolac Ophthalmic Irrigation Solution

Michigan rates for HCPCS J1097

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Rates data updated July 2026.

Facilitymedian $219 · 10th–90th $112$3800%10%10th90th$219Professionalmedian $117 · 10th–90th $112$1660%50%10th90th$117$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$199.53
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$154.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$263.03
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$120.23
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$316.23
Typical High
$398.11
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$151.36
Typical High
$204.17
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$97.72
Typical High
$97.72
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$131.83