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%-Epi 1:100000 20ML
Flandreau, SD
See all hospitals reporting HCPCS J2004 →Price type
Avera Flandreau Hospital’s median price of $114 is 1631% above the median hospital's median price ($7), higher than 97% 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: 4 payers, 10 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 | Medica com fee schedule · outpatient | $4.70 | $4.70 | $4.70 – $4.70 |
| 2 | Medica ind fee schedule · outpatient | $4.70 | $4.70 | $4.70 – $4.70 |
| 3 | Medica ind percent of total billed charges · inpatientfrom % of charges | $107.31 | $107.31 | $107.31 – $107.31 |
| 4 | Wellmark ppo percent of total billed charges · inpatientfrom % of charges | $113.91 | $113.91 | $113.91 – $113.91 |
| 5 | Wellmark ppo percent of total billed charges · outpatientfrom % of charges | $113.91 | $113.91 | $113.91 – $113.91 |
| 6 | Medica com percent of total billed charges · inpatientfrom % of charges | $127.45 | $127.45 | $127.45 – $127.45 |
| 7 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $140.82 | $140.82 | $140.82 – $140.82 |
| 8 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $140.82 | $140.82 | $140.82 – $140.82 |
| 9 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $156.84 | $156.84 | $156.84 – $156.84 |
| 10 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $156.84 | $156.84 | $156.84 – $156.84 |
Last updated: Apr 1, 2026
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