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 (Xylocaine W/Epi) 1 %-1:100000 injection 1 mL
Port Arthur, TX
See all hospitals reporting HCPCS J2004 →Price type
Christus Health Southeast Texas’s median price of $51 is 674% above the median hospital's median price ($7), higher than 89% 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: 11 payers, 30 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 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $0.04 | $0.04 | $0.04 – $0.04 |
| 2 | UnitedHealthcare all payer fee schedule · outpatient | $0.04 | $0.04 | $0.04 – $0.04 |
| 3 | UnitedHealthcare hix fee schedule · outpatient | $0.04 | $0.04 | $0.04 – $0.04 |
| 4 | Bcbs Tx heb fee schedule · outpatient | $0.05 | $0.05 | $0.05 – $0.05 |
| 5 | Bcbs Tx hmo fee schedule · outpatient | $0.05 | $0.05 | $0.05 – $0.05 |
| 6 | Bcbs Tx ppo fee schedule · outpatient | $0.05 | $0.05 | $0.05 – $0.05 |
| 7 | Bcbs Tx traditional fee schedule · outpatient | $0.06 | $0.06 | $0.06 – $0.06 |
| 8 | UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges | $18.19 | $23.34 | $0.89 – $127.32 |
| 9 | UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges | $18.19 | $23.34 | $0.89 – $127.32 |
| 10 | UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges | $18.19 | $23.34 | $0.89 – $127.32 |
| 11 | UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges | $18.19 | $23.34 | $0.89 – $127.32 |
| 12 | Aetna mm percent of total billed charges · outpatientfrom % of charges | $43.65 | $56.02 | $2.15 – $305.58 |
| 13 | UnitedHealthcare hix percent of total billed charges · outpatientfrom % of charges | $50.93 | $64.12 | $2.51 – $356.51 |
| 14 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $54.57 | $68.70 | $2.69 – $381.98 |
| 15 | Molina chip km percent of total billed charges · outpatientfrom % of charges | $54.57 | $70.03 | $2.69 – $381.98 |
| 16 | Molina star km percent of total billed charges · outpatientfrom % of charges | $54.57 | $70.03 | $2.69 – $381.98 |
| 17 | Molina star plus km percent of total billed charges · outpatientfrom % of charges | $54.57 | $70.03 | $2.69 – $381.98 |
| 18 | Cigna new business percent of total billed charges · outpatientfrom % of charges | $70.94 | $91.04 | $3.50 – $496.57 |
| 19 | Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges | $81.85 | $105.05 | $4.04 – $572.97 |
| 20 | Devoted mm percent of total billed charges · outpatientfrom % of charges | $90.95 | $116.72 | $4.49 – $636.64 |
| 21 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $109.14 | $140.06 | $5.38 – $763.96 |
| 22 | Humana choicecare percent of total billed charges · outpatientfrom % of charges | $109.14 | $140.06 | $5.38 – $763.96 |
| 23 | Aetna new business percent of total billed charges · outpatientfrom % of charges | $112.77 | $144.73 | $5.56 – $789.43 |
| 24 | First Health ppo percent of total billed charges · outpatientfrom % of charges | $118.23 | $151.74 | $5.83 – $827.63 |
| 25 | Aetna epo percent of total billed charges · outpatientfrom % of charges | $125.51 | $161.07 | $6.19 – $878.56 |
Last updated: Jan 13, 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.