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
LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION
Henryetta, OK
See all hospitals reporting HCPCS J2004 →Price type
AHS Henryetta Hospital, LLC’s median price of $64 is 875% above the median hospital's median price ($7), higher than 93% 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: 6 payers, 9 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 aetna aco wilco [101532] facility · percent of total billed charges · bothfrom % of charges | $51.40 | $43.91 | $28.92 – $51.40 |
| 2 | Cigna cigna [126008] facility · percent of total billed charges · bothfrom % of charges | $64.17 | $54.81 | $36.10 – $64.17 |
| 3 | Healthpartners healthpartners [150000] facility · percent of total billed charges · bothfrom % of charges | $64.17 | $54.81 | $36.10 – $64.17 |
| 4 | First Health benveo/ucs [137512] facility · percent of total billed charges · bothfrom % of charges | $79.39 | $67.81 | $44.66 – $79.39 |
| 5 | MultiPlan providence health plan [168004] facility · percent of total billed charges · bothfrom % of charges | $79.39 | $67.81 | $44.66 – $79.39 |
| 6 | Phcs lifestyle health plans [178013] facility · percent of total billed charges · bothfrom % of charges | $93.67 | $80.01 | $52.70 – $93.67 |
| 7 | First Health tall tree administrators [137508] facility · percent of total billed charges · bothfrom % of charges | $100.70 | $86.02 | $56.65 – $100.70 |
| 8 | MultiPlan ihc hs [168011] facility · percent of total billed charges · bothfrom % of charges | $100.70 | $86.02 | $56.65 – $100.70 |
| 9 | Phcs group health cooperative scw [178012] facility · percent of total billed charges · bothfrom % of charges | $100.70 | $86.02 | $56.65 – $100.70 |
Last updated: Mar 21, 2026
See Lidocaine with epinephrine injection pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.