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
XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION
Cleveland, OH
See all hospitals reporting HCPCS J2004 →Price type
Fairview Hospital’s median price of $1 is 86% below the median hospital's median price ($7), higher than 41% 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: 10 payers, 22 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 | Aetna acop facility · fee schedule · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 2 | Aetna international facility · fee schedule · outpatient | $0.02 | $0.02 | $0.02 – $0.02 |
| 3 | UnitedHealthcare all products facility · fee schedule · outpatient | $0.06 | $0.06 | $0.06 – $0.06 |
| 4 | Anthem hpn facility · percent of total billed charges · outpatientfrom % of charges | $0.19 | $0.30 | $0.12 – $0.73 |
| 5 | Anthem ppo/hmo facility · percent of total billed charges · outpatientfrom % of charges | $0.22 | $0.36 | $0.14 – $0.86 |
| 6 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $0.27 | $0.42 | $0.16 – $1.02 |
| 7 | Oscar all products facility · percent of total billed charges · outpatientfrom % of charges | $0.35 | $0.55 | $0.21 – $1.32 |
| 8 | Oscar all products facility · percent of total billed charges · inpatientfrom % of charges | $0.44 | $0.71 | $0.27 – $1.69 |
| 9 | Anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $0.69 | $1.09 | $0.42 – $2.61 |
| 10 | Optum all products transplant facility · percent of total billed charges · outpatientfrom % of charges | $0.70 | $1.11 | $0.42 – $2.65 |
| 11 | Anthem traditional facility · percent of total billed charges · inpatientfrom % of charges | $0.71 | $1.13 | $0.43 – $2.70 |
| 12 | Aetna all products facility · percent of total billed charges · bothfrom % of charges | $0.92 | $1.47 | $0.56 – $3.51 |
| 13 | Cigna all products psychiatrist facility · percent of total billed charges · outpatientfrom % of charges | $0.98 | $1.56 | $0.60 – $3.74 |
| 14 | Humana all products facility · percent of total billed charges · bothfrom % of charges | $1.05 | $1.66 | $0.64 – $3.98 |
| 15 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $1.11 | $1.76 | $0.68 – $4.21 |
| 16 | Aetna qhp/ipf facility · percent of total billed charges · bothfrom % of charges | $1.23 | $1.95 | $0.75 – $4.68 |
| 17 | Aetna asa_whirlpool_peia facility · other · outpatient | $2.17 | $2.17 | $2.17 – $2.17 |
| 18 | Optum managed medicaid transplant facility · case rate · outpatient | $7.89 | $7.89 | $7.89 – $7.89 |
| 19 | Anthem managed medicaid facility · case rate · outpatient | $8.73 | $8.73 | $8.73 – $8.73 |
| 20 | Molina managed medicaid facility · case rate · outpatient | $8.73 | $8.73 | $8.73 – $8.73 |
| 21 | Caresource managed medicaid facility · case rate · outpatient | $8.89 | $8.89 | $8.89 – $8.89 |
| 22 | UnitedHealthcare managed medicaid facility · case rate · outpatient | $8.89 | $8.89 | $8.89 – $8.89 |
Last updated: Jun 15, 2026
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