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-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION
Peabody, MA
See all hospitals reporting HCPCS J2004 →Price type
Boston Children's Hospital’s median price of $43 is 548% above the median hospital's median price ($7), higher than 85% 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: 8 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 | Blue Cross Blue Shield all products sat outpatient fee schedule · both | $0.01 | $0.01 | $0.01 – $0.01 |
| 2 | UnitedHealthcare medicare inpatient/outpatient percent of total billed charges · bothfrom % of charges | $39.22 | $39.63 | $16.87 – $77.47 |
| 3 | Aetna medicaid inpatient/outpatient percent of total billed charges · bothfrom % of charges | $39.34 | $39.75 | $16.93 – $77.71 |
| 4 | Optum medicaid/medicare inpatient/outpatient percent of total billed charges · bothfrom % of charges | $42.62 | $43.07 | $18.34 – $84.19 |
| 5 | Blue Cross Blue Shield indem outpatient percent of total billed charges · bothfrom % of charges | $43.29 | $43.74 | $18.62 – $85.51 |
| 6 | Optum comm chd onc outpatient percent of total billed charges · bothfrom % of charges | $54.42 | $54.99 | $23.42 – $107.50 |
| 7 | UnitedHealthcare comm inpatient/outpatient percent of total billed charges · bothfrom % of charges | $54.79 | $55.36 | $23.57 – $108.22 |
| 8 | Aetna comm inpatient/outpatient percent of total billed charges · bothfrom % of charges | $54.97 | $55.54 | $23.65 – $108.58 |
| 9 | Optum comm outpatient percent of total billed charges · bothfrom % of charges | $55.74 | $56.32 | $23.98 – $110.09 |
| 10 | Cigna all products outpatient percent of total billed charges · bothfrom % of charges | $57.46 | $58.05 | $23.98 – $116.88 |
| 11 | Humana all products inpatient/outpatient percent of total billed charges · bothfrom % of charges | $59.01 | $59.63 | $25.39 – $116.57 |
| 12 | First Health all products inpatient/outpatient percent of total billed charges · bothfrom % of charges | $60.33 | $60.96 | $25.95 – $119.16 |
| 13 | MultiPlan phcs clients inpatient/outpatient percent of total billed charges · bothfrom % of charges | $60.33 | $60.96 | $25.95 – $119.16 |
| 14 | MultiPlan multiplan clients inpatient/outpatient percent of total billed charges · bothfrom % of charges | $62.29 | $62.94 | $26.80 – $123.05 |
Last updated: Apr 1, 2026
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