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
Lido 2% Epi 1:100000 20ML Vial
Rock Rapids, IA
See all hospitals reporting HCPCS J2004 →Price type
Avera Merrill Pioneer’s median price of $135 is 1957% 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, 12 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 | Wellmark hmo fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 2 | Wellmark ppo fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 3 | Medica com fee schedule · outpatient | $4.70 | $4.70 | $4.70 – $4.70 |
| 4 | Medica ind fee schedule · outpatient | $4.70 | $4.70 | $4.70 – $4.70 |
| 5 | Medica ind percent of total billed charges · inpatientfrom % of charges | $107.27 | $107.27 | $105.84 – $108.69 |
| 6 | Medica com percent of total billed charges · inpatientfrom % of charges | $127.40 | $127.40 | $125.70 – $129.09 |
| 7 | Wellmark hmo percent of total billed charges · inpatientfrom % of charges | $135.32 | $135.32 | $133.52 – $137.12 |
| 8 | Wellmark ppo percent of total billed charges · inpatientfrom % of charges | $135.32 | $135.32 | $133.52 – $137.12 |
| 9 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $140.77 | $140.77 | $138.89 – $142.64 |
| 10 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $140.77 | $140.77 | $138.89 – $142.64 |
| 11 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $151.82 | $151.82 | $149.80 – $153.84 |
| 12 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $151.82 | $151.82 | $149.80 – $153.84 |
Last updated: Apr 1, 2026
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