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
Cannon, NC
See all hospitals reporting HCPCS J2004 →Price type
Charles A. Cannon Jr. Memorial Hospital, Inc’s median price of $11 is 70% above the median hospital's median price ($7), higher than 58% 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, 19 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 | UnitedHealthcare commercial facility · fee schedule · outpatient | $0.12 | $0.12 | $0.12 – $0.12 |
| 2 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $10.07 | $10.27 | $9.88 – $11.12 |
| 3 | Optum vaccn facility · percent of total billed charges · outpatientfrom % of charges | $10.10 | $10.30 | $9.90 – $11.15 |
| 4 | Optum vaccn behavioral health facility · percent of total billed charges · outpatientfrom % of charges | $10.10 | $10.30 | $9.90 – $11.15 |
| 5 | Amerihealth Caritas managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $10.20 | $10.40 | $10.01 – $11.26 |
| 6 | Humana medicare hmo/medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $10.20 | $10.40 | $10.00 – $11.26 |
| 7 | UnitedHealthcare chip/medicaid facility · percent of total billed charges · outpatientfrom % of charges | $10.20 | $10.40 | $10.01 – $11.26 |
| 8 | WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $10.30 | $10.51 | $10.11 – $11.37 |
| 9 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $10.70 | $10.91 | $10.50 – $11.82 |
| 10 | Blue Cross Blue Shield blue select/blue value/hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $12.56 | $12.80 | $12.32 – $13.86 |
| 11 | Blue Cross Blue Shield blue select/blue value/hmo/ppo facility · percent of total billed charges · inpatientfrom % of charges | $16.37 | $16.69 | $16.05 – $18.07 |
| 12 | Medcost ultra facility · percent of total billed charges · outpatientfrom % of charges | $16.79 | $17.12 | $16.47 – $18.54 |
| 13 | Medcost ultra facility · percent of total billed charges · inpatientfrom % of charges | $18.01 | $18.37 | $17.67 – $19.89 |
| 14 | UnitedHealthcare individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $18.64 | $19.01 | $18.28 – $20.58 |
| 15 | UnitedHealthcare individual exchange facility · percent of total billed charges · inpatientfrom % of charges | $19.85 | $20.24 | $19.47 – $21.91 |
| 16 | Medcost standard facility · percent of total billed charges · outpatientfrom % of charges | $20.11 | $20.51 | $19.73 – $22.21 |
| 17 | Medcost standard facility · percent of total billed charges · inpatientfrom % of charges | $21.43 | $21.85 | $21.02 – $23.66 |
| 18 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $24.52 | $25.01 | $24.05 – $27.07 |
| 19 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $30.29 | $30.89 | $29.71 – $33.44 |
Last updated: Jun 4, 2026
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