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) 2 %-1:200,000 INJECTION SOLUTION
Carthage, TX
See all hospitals reporting HCPCS J2004 →Price type
Carthage Hospital, LLC’s median price of $39 is 490% above the median hospital's median price ($7), higher than 84% 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, 15 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 bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $27.87 | $17.86 – $49.08 |
| 2 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $27.87 | $17.86 – $49.08 |
| 3 | Molina molina medicaid new mexico [225500] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $27.87 | $17.86 – $49.08 |
| 4 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $27.87 | $17.86 – $49.08 |
| 5 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $21.58 | $28.97 | $18.57 – $51.02 |
| 6 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $21.58 | $28.97 | $18.57 – $51.02 |
| 7 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $21.58 | $28.97 | $18.57 – $51.02 |
| 8 | UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges | $42.73 | $57.36 | $36.76 – $101.02 |
| 9 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $42.73 | $57.36 | $36.76 – $101.02 |
| 10 | Cigna cigna ppo [126025] facility · percent of total billed charges · bothfrom % of charges | $48.17 | $64.66 | $41.44 – $113.88 |
| 11 | Aetna aetna [101529] facility · percent of total billed charges · bothfrom % of charges | $52.75 | $70.80 | $45.37 – $124.69 |
| 12 | Aetna meritain aetna [368500] facility · percent of total billed charges · bothfrom % of charges | $52.75 | $70.80 | $45.37 – $124.69 |
| 13 | Cigna cigna - great west [126009] facility · percent of total billed charges · bothfrom % of charges | $54.39 | $73.00 | $46.78 – $128.57 |
| 14 | Humana humana commercial [214001] facility · percent of total billed charges · bothfrom % of charges | $54.39 | $73.00 | $46.78 – $128.57 |
| 15 | Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges | $54.39 | $73.00 | $46.78 – $128.57 |
Last updated: Feb 12, 2026
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