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
Gregory, SD
See all hospitals reporting HCPCS J2004 →Price type
Avera Gregory Hospital’s median price of $144 is 2095% above the median hospital's median price ($7), higher than 98% 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, 11 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 | Wellmark hmo outpatient | $23.92 | $23.92 | $23.92 – $23.92 |
| 4 | Medica ind percent of total billed charges · inpatientfrom % of charges | $110.08 | $110.08 | $110.08 – $110.08 |
| 5 | Medica com percent of total billed charges · inpatientfrom % of charges | $130.74 | $130.74 | $130.74 – $130.74 |
| 6 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $144.46 | $144.46 | $144.46 – $144.46 |
| 7 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $144.46 | $144.46 | $144.46 – $144.46 |
| 8 | Wellmark ppo percent of total billed charges · inpatientfrom % of charges | $149.03 | $149.03 | $149.03 – $149.03 |
| 9 | Wellmark ppo percent of total billed charges · outpatientfrom % of charges | $149.03 | $149.03 | $149.03 – $149.03 |
| 10 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $160.88 | $160.88 | $160.88 – $160.88 |
| 11 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $160.88 | $160.88 | $160.88 – $160.88 |
Last updated: Apr 1, 2026
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