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 (PF) 2 %-1:200,000 INJECTION SOLUTION
Panguitch, UT
See all hospitals reporting HCPCS J2004 →Price type
Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital’s median price of $22 is 242% above the median hospital's median price ($7), higher than 71% 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, 37 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 aetna medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $8.99 | $12.14 | $8.88 – $18.54 |
| 2 | Aetna aetna medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $8.99 | $12.14 | $8.88 – $18.54 |
| 3 | Molina medicaid facility · percent of total billed charges · outpatientfrom % of charges | $8.99 | $12.14 | $8.88 – $18.54 |
| 4 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · outpatientfrom % of charges | $8.99 | $12.14 | $8.88 – $18.54 |
| 5 | Molina molina medicare complete care hmo snp facility · percent of total billed charges · outpatientfrom % of charges | $9.94 | $13.42 | $9.82 – $20.49 |
| 6 | Tricare tricare (hnfs) military program facility · percent of total billed charges · outpatientfrom % of charges | $10.25 | $13.83 | $10.12 – $21.13 |
| 7 | Tricare tricare (hnfs) military program facility · percent of total billed charges · inpatientfrom % of charges | $12.19 | $16.45 | $12.04 – $25.13 |
| 8 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $19.40 | $26.19 | $19.16 – $40.00 |
| 9 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $19.87 | $26.83 | $19.63 – $40.98 |
| 10 | Molina medicaid facility · percent of total billed charges · inpatientfrom % of charges | $21.06 | $28.42 | $20.80 – $43.41 |
| 11 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · inpatientfrom % of charges | $21.06 | $28.42 | $20.80 – $43.41 |
| 12 | Aetna aetna extended network facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 13 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 14 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 15 | Aetna aetna utah connected network facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 16 | Aetna aetna utah connected network facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 17 | Aetna aetna whole health connected utah network facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 18 | Blue Cross Blue Shield bcbs association-blue card ppo plan facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 19 | Blue Cross Blue Shield bcbs association-blue card ppo plan facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 20 | Blue Cross Blue Shield bcbs association-blue card traditional plan facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 21 | Blue Cross Blue Shield bcbs association-blue card traditional plan facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 22 | Cigna cigna managed care (hmo or open access plus aka oap) facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 23 | Cigna cigna managed care (hmo or open access plus aka oap) facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 24 | Cigna cigna open access flex facility · percent of total billed charges · inpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
| 25 | Cigna cigna open access flex facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $30.34 | $22.20 – $46.34 |
Last updated: Aug 5, 2026
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