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 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION
American Fork, UT
See all hospitals reporting HCPCS J2004 →Price type
IHC Health Services Inc., DBA Intermountain Health American Fork Hospital’s median price of $33 is 401% above the median hospital's median price ($7), higher than 79% 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: 4 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | UnitedHealthcare charter ut facility · percent of total billed charges · inpatientfrom % of charges | $31.14 | $38.12 | $14.40 – $84.60 |
| 2 | UnitedHealthcare charter ut facility · percent of total billed charges · outpatientfrom % of charges | $31.14 | $38.12 | $14.40 – $84.60 |
| 3 | Regence blueoption facility · percent of total billed charges · inpatientfrom % of charges | $32.05 | $39.23 | $14.82 – $87.07 |
| 4 | Regence blueoption facility · percent of total billed charges · outpatientfrom % of charges | $32.05 | $39.23 | $14.82 – $87.07 |
| 5 | Cigna open access flex facility · percent of total billed charges · inpatientfrom % of charges | $32.70 | $40.03 | $15.12 – $88.83 |
| 6 | Cigna open access flex facility · percent of total billed charges · outpatientfrom % of charges | $32.70 | $40.03 | $15.12 – $88.83 |
| 7 | Regence high performance facility · percent of total billed charges · inpatientfrom % of charges | $36.33 | $44.47 | $16.80 – $98.70 |
| 8 | Regence fehbp facility · percent of total billed charges · inpatientfrom % of charges | $36.59 | $44.79 | $16.92 – $99.40 |
| 9 | Regence fehbp facility · percent of total billed charges · outpatientfrom % of charges | $36.59 | $44.79 | $16.92 – $99.40 |
| 10 | UnitedHealthcare non-options ppo facility · percent of total billed charges · inpatientfrom % of charges | $36.85 | $45.11 | $17.04 – $100.11 |
| 11 | UnitedHealthcare non-options ppo facility · percent of total billed charges · outpatientfrom % of charges | $36.85 | $45.11 | $17.04 – $100.11 |
| 12 | Regence traditional facility · percent of total billed charges · inpatientfrom % of charges | $39.45 | $48.29 | $18.24 – $107.16 |
| 13 | Regence traditional facility · percent of total billed charges · outpatientfrom % of charges | $39.45 | $48.29 | $18.24 – $107.16 |
| 14 | Aetna connected facility · percent of total billed charges · inpatientfrom % of charges | $41.52 | $50.83 | $19.20 – $112.80 |
| 15 | Aetna connected facility · percent of total billed charges · outpatientfrom % of charges | $42.04 | $51.46 | $19.44 – $114.21 |
| 16 | Aetna extended facility · percent of total billed charges · inpatientfrom % of charges | $44.12 | $54.00 | $20.40 – $119.85 |
| 17 | Aetna extended facility · percent of total billed charges · outpatientfrom % of charges | $44.12 | $54.00 | $20.40 – $119.85 |
| 18 | Cigna ppo/epo facility · percent of total billed charges · inpatientfrom % of charges | $44.12 | $54.00 | $20.40 – $119.85 |
| 19 | Cigna ppo/epo facility · percent of total billed charges · outpatientfrom % of charges | $44.12 | $54.00 | $20.40 – $119.85 |
| 20 | UnitedHealthcare options ppo facility · percent of total billed charges · inpatientfrom % of charges | $44.12 | $54.00 | $20.40 – $119.85 |
| 21 | UnitedHealthcare options ppo facility · percent of total billed charges · outpatientfrom % of charges | $44.12 | $54.00 | $20.40 – $119.85 |
Last updated: Aug 5, 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.