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
EPINEPHrine-lidocaine (Xylocaine/epi) 1:100,000-1% 20 mL MDV injectable solution
Tustin, CA
See all hospitals reporting HCPCS J2004 →Price type
Alta Newport Hospital, LLC’s median price of $71 is 981% 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: 7 payers, 18 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 | Bcbs Ca covered california/ifp/ppo facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 2 | Bcbs Ca epo/ppo/out of state facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 3 | Bcbs Ca hmo facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 4 | Aetna all gatekeeper plans facility · case rate · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 5 | Aetna all non-gatekeeper plans facility · case rate · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 6 | Cigna hmo/ppo facility · percent of total billed charges · inpatientfrom % of charges | $60.00 | $60.00 | $60.00 – $60.00 |
| 7 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $60.00 | $60.00 | $60.00 – $60.00 |
| 8 | UnitedHealthcare managed care facility · percent of total billed charges · inpatientfrom % of charges | $64.64 | $64.64 | $64.64 – $64.64 |
| 9 | Aetna exchange facility · percent of total billed charges · inpatientfrom % of charges | $71.14 | $71.14 | $71.14 – $71.14 |
| 10 | Aetna exchange facility · percent of total billed charges · outpatientfrom % of charges | $71.14 | $71.14 | $71.14 – $71.14 |
| 11 | Aetna all gatekeeper plans facility · percent of total billed charges · inpatientfrom % of charges | $92.89 | $92.89 | $92.89 – $92.89 |
| 12 | Aetna all non-gatekeeper plans facility · percent of total billed charges · inpatientfrom % of charges | $92.89 | $92.89 | $92.89 – $92.89 |
| 13 | Anthem commercial hmo-ppo/covered california facility · percent of total billed charges · outpatientfrom % of charges | $115.20 | $115.20 | $115.20 – $115.20 |
| 14 | Anthem ppg facility · percent of total billed charges · outpatientfrom % of charges | $144.02 | $144.02 | $144.02 – $144.02 |
| 15 | Phcs commercial ppo facility · percent of total billed charges · inpatientfrom % of charges | $170.74 | $170.74 | $170.74 – $170.74 |
| 16 | Phcs commercial ppo facility · percent of total billed charges · outpatientfrom % of charges | $170.74 | $170.74 | $170.74 – $170.74 |
| 17 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $203.94 | $203.94 | $203.94 – $203.94 |
| 18 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $203.94 | $203.94 | $203.94 – $203.94 |
Last updated: Mar 18, 2026
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