Intravenous lidocaine infusion in dextrose solution

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION

Payers reporting HCPCS J2002

Payer pricing summary

Low

Average

$321

Median

$36

High

$7.3k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +26 other terms	538	$0	$8	$24	309%	—	— – $236
2	Cigna fee schedule · outpatient · +24 other terms	310	$0	$59	$473	807%	—	— – $4.6k
3	Aetna fee schedule · outpatient · +24 other terms	239	$0	$11	$30	278%	—	— – $351
4	Blue Cross Blue Shield fee schedule · outpatient · +26 other terms	211	$0	$6	$19	319%	—	— – $146
5	Humana fee schedule · outpatient · +19 other terms	167	$0	$7	$21	278%	—	— – $140
6	Anthem fee schedule · outpatient · +19 other terms	101	$0	$17	$36	220%	—	$0 – $236
7	MultiPlan fee schedule · outpatient · +12 other terms	63	$60	$74	$60	82%	—	$0 – $294
8	Kaiser fee schedule · both · +14 other terms	41	$0	$0	—	—	—	$0 – $0
9	Caresource fee schedule · outpatient · +13 other terms	40	$0	$1	$5	349%	—	$0 – $24
10	First Health fee schedule · outpatient · +15 other terms	36	$48	$57	$42	73%	—	$0 – $194
11	Medcost facility · percent of total billed charges · bothfrom % of charges · +5 other terms	34	$58	$54	$30	56%	—	$11 – $85
12	Molina fee schedule · outpatient · +18 other terms	31	$0	$9	$28	304%	—	— – $151
13	Highmark facility · fee schedule · outpatient · +14 other terms	29	—	—	—	—	—	— – $0
14	Medicaid facility · fee schedule · outpatient · +7 other terms	27	$20	$61	$98	161%	—	$0 – $282
15	Optum fee schedule · outpatient · +14 other terms	27	—	$11	$19	175%	—	— – $66
16	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$29	$26	$4	17%	—	$19 – $34
17	WellCare fee schedule · outpatient · +13 other terms	26	$0	$1	$3	471%	—	— – $18
18	Amerihealth Caritas other · outpatient · +12 other terms	25	$35	$975	$1.7k	176%	—	$5 – $4.1k
19	Beechstreet percent of total billed charges · outpatientfrom % of charges · +4 other terms	22	$61	$71	$28	39%	—	$15 – $173
20	Bcbs La fee schedule · outpatient · +3 other terms	20	$0	$0	—	—	—	— – $0
21	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +3 other terms	20	$20	$31	$35	115%	—	$0 – $149
22	Aetna Better Health other · outpatient · +10 other terms	19	$21	$50	$96	193%	—	$5 – $423
23	Ambetter other · outpatient · +12 other terms	19	$140	$673	$1.4k	205%	—	$24 – $4.1k
24	Bcbs Tx fee schedule · outpatient · +3 other terms	19	$0	$0	$0	25%	—	$0 – $0
25	Medica fee schedule · outpatient · +13 other terms	18	$17	$20	$25	128%	—	$1 – $170

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