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
Amarillo, TX
See all hospitals reporting HCPCS J2004 →Price type
BSA Hospital’s median price of $101 is 1441% above the median hospital's median price ($7), higher than 96% 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: 10 payers, 24 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Blue Cross Blue Shield bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges | $19.84 | $20.88 | $7.41 – $43.99 |
| 2 | Blue Cross Blue Shield bcbs tx medicaid chip [116506] facility · percent of total billed charges · bothfrom % of charges | $19.84 | $20.88 | $7.41 – $43.99 |
| 3 | Aetna aetna better health [351001] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 4 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 5 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 6 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 7 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 8 | UnitedHealthcare uhc comm mcaid health pla [225001] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 9 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $82.68 | $87.01 | $30.89 – $183.30 |
| 10 | UnitedHealthcare united healthcare core exclusive [206022] facility · percent of total billed charges · bothfrom % of charges | $90.74 | $95.49 | $33.90 – $201.16 |
| 11 | UnitedHealthcare uhc surest bind [206032] facility · percent of total billed charges · bothfrom % of charges | $129.96 | $136.77 | $48.55 – $288.11 |
| 12 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $129.96 | $136.77 | $48.55 – $288.11 |
| 13 | Aetna aetna client specific [101506] facility · percent of total billed charges · bothfrom % of charges | $137.80 | $145.02 | $51.48 – $305.50 |
| 14 | Medica medica harmony [291000] facility · percent of total billed charges · bothfrom % of charges | $148.40 | $156.18 | $55.44 – $329.00 |
| 15 | Phcs freedom life [178009] facility · percent of total billed charges · bothfrom % of charges | $148.40 | $156.18 | $55.44 – $329.00 |
| 16 | Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges | $148.40 | $156.18 | $55.44 – $329.00 |
| 17 | Cigna cigna [126008] facility · percent of total billed charges · bothfrom % of charges | $153.91 | $161.98 | $57.50 – $341.22 |
| 18 | Healthpartners healthpartners [150000] facility · percent of total billed charges · bothfrom % of charges | $153.91 | $161.98 | $57.50 – $341.22 |
| 19 | UnitedHealthcare united healthcare shared svcs [206010] facility · percent of total billed charges · bothfrom % of charges | $154.12 | $162.20 | $57.58 – $341.69 |
| 20 | Aetna american continental [101507] facility · percent of total billed charges · bothfrom % of charges | $159.00 | $167.33 | $59.40 – $352.50 |
| 21 | Aetna meritain aetna [368500] facility · percent of total billed charges · bothfrom % of charges | $159.00 | $167.33 | $59.40 – $352.50 |
| 22 | Cigna cigna pantex [126003] facility · percent of total billed charges · bothfrom % of charges | $167.51 | $177.69 | $144.67 – $220.90 |
| 23 | Kaiser kaiser permanete oakland ca [156000] facility · percent of total billed charges · bothfrom % of charges | $180.20 | $189.64 | $67.32 – $399.50 |
| 24 | MultiPlan international benefits administrators [168005] facility · percent of total billed charges · bothfrom % of charges | $180.20 | $189.64 | $67.32 – $399.50 |
Last updated: Feb 12, 2026
See Lidocaine with epinephrine injection pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.