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 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION
Athens, TX
See all hospitals reporting HCPCS J2004 →Price type
Athens Hospital, LLC’s median price of $38 is 474% above the median hospital's median price ($7), higher than 83% 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, 14 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 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $20.08 | $31.62 | $13.13 – $77.90 |
| 2 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $20.08 | $31.62 | $13.13 – $77.90 |
| 3 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $20.08 | $31.62 | $13.13 – $77.90 |
| 4 | Blue Cross Blue Shield bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges | $24.42 | $38.46 | $15.97 – $94.77 |
| 5 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $24.42 | $38.46 | $15.97 – $94.77 |
| 6 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $24.42 | $38.46 | $15.97 – $94.77 |
| 7 | UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges | $39.75 | $62.60 | $25.99 – $154.25 |
| 8 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $39.75 | $62.60 | $25.99 – $154.25 |
| 9 | Cigna cigna ppo [126025] facility · percent of total billed charges · bothfrom % of charges | $44.81 | $70.57 | $29.30 – $173.88 |
| 10 | Aetna aetna [101529] facility · percent of total billed charges · bothfrom % of charges | $50.43 | $79.42 | $32.98 – $195.69 |
| 11 | Aetna meritain aetna [368500] facility · percent of total billed charges · bothfrom % of charges | $50.43 | $79.42 | $32.98 – $195.69 |
| 12 | Cigna cigna - great west [126009] facility · percent of total billed charges · bothfrom % of charges | $51.39 | $80.93 | $33.61 – $199.43 |
| 13 | Humana humana commercial [214001] facility · percent of total billed charges · bothfrom % of charges | $51.39 | $80.93 | $33.61 – $199.43 |
| 14 | Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges | $51.39 | $80.93 | $33.61 – $199.43 |
Last updated: Mar 31, 2026
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