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
LIDO/EPI 2%1:100K 30MLMDV
Glendale, CA
See all hospitals reporting HCPCS J2004 →Price type
Dignity Community Care’s median price of $31 is 378% above the median hospital's median price ($7), higher than 78% 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: 7 payers, 18 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 | Anthem medicaid|all plans fee schedule · inpatient | $19.00 | $19.93 | $6.50 – $40.00 |
| 2 | Anthem medicaid|all plans fee schedule · outpatient | $19.00 | $19.93 | $6.50 – $40.00 |
| 3 | Cigna commercial|all other plans fee schedule · outpatient | $34.96 | $36.67 | $11.96 – $73.60 |
| 4 | Cigna commercial|ppo fee schedule · outpatient | $34.96 | $36.67 | $11.96 – $73.60 |
| 5 | Kaiser commercial|all plans fee schedule · inpatient | $42.56 | $44.65 | $14.56 – $89.60 |
| 6 | Kaiser commercial|all plans fee schedule · outpatient | $42.56 | $44.65 | $14.56 – $89.60 |
| 7 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $45.60 | $47.84 | $15.60 – $96.00 |
| 8 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $45.60 | $47.84 | $15.60 – $96.00 |
| 9 | First Health commercial|all plans fee schedule · inpatient | $49.40 | $51.82 | $16.90 – $104.00 |
| 10 | First Health commercial|all plans fee schedule · outpatient | $49.40 | $51.82 | $16.90 – $104.00 |
| 11 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $57.76 | $60.59 | $19.76 – $121.60 |
| 12 | MultiPlan commercial|all plans fee schedule · inpatient | $60.80 | $63.78 | $20.80 – $128.00 |
| 13 | MultiPlan commercial|all plans fee schedule · outpatient | $60.80 | $63.78 | $20.80 – $128.00 |
| 14 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $68.40 | $71.75 | $23.40 – $144.00 |
| 15 | Anthem commercial|non-mcs fee schedule · outpatient | $69.92 | $73.35 | $23.92 – $147.20 |
| 16 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $71.44 | $74.94 | $24.44 – $150.40 |
| 17 | Anthem commercial|mcs fee schedule · outpatient | $76.00 | $79.73 | $26.00 – $160.00 |
| 18 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $76.00 | $79.73 | $26.00 – $160.00 |
Last updated: Feb 28, 2026
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