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.
Original text from hospital filings
LIDO/EPI 1%-1:100K1ML(20ML)MDV
Mesa, AZ
See all hospitals reporting HCPCS J2004 →Price type
Agh Mesa Llc’s median price of $14 is 118% above the median hospital's median price ($7), higher than 63% of the 1,679 hospitals reporting HCPCS J2004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 6 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Aetna commercial|all other plans fee schedule · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 2 | Aetna commercial|ppo fee schedule · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 3 | Cigna commercial|all other plans fee schedule · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 4 | Cigna commercial|ppo fee schedule · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 5 | MultiPlan commercial|all plans fee schedule · inpatient | $44.12 | $44.12 | $44.12 – $44.12 |
| 6 | MultiPlan commercial|all plans fee schedule · outpatient | $44.12 | $44.12 | $44.12 – $44.12 |
Last updated: Feb 28, 2026
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