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/EPI1.5% 1:200000 30M
Woodland, CA
See all hospitals reporting HCPCS J2004 →Price type
Dignity Community Care’s median price of $47 is 607% above the median hospital's median price ($7), higher than 87% 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, 21 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 | Kaiser medicaid|all plans fee schedule · inpatient | $26.04 | $26.09 | $20.50 – $31.57 |
| 2 | Kaiser medicaid|all plans fee schedule · outpatient | $26.04 | $26.09 | $20.50 – $31.57 |
| 3 | Cigna commercial|localplus fee schedule · inpatient | $26.67 | $26.72 | $21.00 – $32.34 |
| 4 | Cigna commercial|localplus fee schedule · outpatient | $26.67 | $26.72 | $21.00 – $32.34 |
| 5 | Kaiser commercial|all plans fee schedule · inpatient | $34.29 | $34.36 | $27.00 – $41.58 |
| 6 | Kaiser commercial|all plans fee schedule · outpatient | $34.29 | $34.36 | $27.00 – $41.58 |
| 7 | Cigna commercial|all other plans fee schedule · inpatient | $35.56 | $35.63 | $28.00 – $43.12 |
| 8 | Cigna commercial|all other plans fee schedule · outpatient | $35.56 | $35.63 | $28.00 – $43.12 |
| 9 | Magellan commercial|all plans fee schedule · inpatient | $38.10 | $38.18 | $30.00 – $46.20 |
| 10 | Magellan commercial|all plans fee schedule · outpatient | $38.10 | $38.18 | $30.00 – $46.20 |
| 11 | Anthem commercial|connection epo fee schedule · outpatient | $47.63 | $47.72 | $37.50 – $57.75 |
| 12 | First Health commercial|all plans fee schedule · inpatient | $57.15 | $57.26 | $45.00 – $69.30 |
| 13 | First Health commercial|all plans fee schedule · outpatient | $57.15 | $57.26 | $45.00 – $69.30 |
| 14 | MultiPlan commercial|all plans fee schedule · inpatient | $58.42 | $58.54 | $46.00 – $70.84 |
| 15 | MultiPlan commercial|all plans fee schedule · outpatient | $58.42 | $58.54 | $46.00 – $70.84 |
| 16 | Anthem commercial|all other plans fee schedule · outpatient | $59.06 | $59.17 | $46.50 – $71.61 |
| 17 | Anthem commercial|mcs fee schedule · outpatient | $63.50 | $63.63 | $50.00 – $77.00 |
| 18 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $63.50 | $63.63 | $50.00 – $77.00 |
| 19 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $63.50 | $63.63 | $50.00 – $77.00 |
| 20 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $63.50 | $63.63 | $50.00 – $77.00 |
| 21 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $63.50 | $63.63 | $50.00 – $77.00 |
Last updated: Feb 28, 2026
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