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
Heber City, UT
See all hospitals reporting HCPCS J2004 →Price type
IHC Health Services Inc., DBA Intermountain Health Heber Valley Hospital’s median price of $43 is 557% above the median hospital's median price ($7), higher than 86% 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: 6 payers, 38 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 medicare adv hmo facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 2 | Aetna medicare adv ppo facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 3 | Humana medicare choice ppo facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 4 | Molina medicaid facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 5 | Molina medicare complete care hmo snp facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 6 | Regence medadvantage ppo facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 7 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $15.81 | $17.26 | $6.64 – $31.72 |
| 8 | Cigna open access flex facility · percent of total billed charges · inpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 9 | Cigna open access flex facility · percent of total billed charges · outpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 10 | Molina chip facility · percent of total billed charges · inpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 11 | Molina chip facility · percent of total billed charges · outpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 12 | Molina marketplace facility · percent of total billed charges · inpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 13 | Molina marketplace facility · percent of total billed charges · outpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 14 | Regence fehbp facility · percent of total billed charges · inpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 15 | Regence fehbp facility · percent of total billed charges · outpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 16 | Regence traditional facility · percent of total billed charges · inpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 17 | Regence traditional facility · percent of total billed charges · outpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 18 | Regence valuecare facility · percent of total billed charges · inpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 19 | Regence valuecare facility · percent of total billed charges · outpatientfrom % of charges | $44.80 | $48.91 | $18.82 – $89.89 |
| 20 | Aetna connected facility · percent of total billed charges · inpatientfrom % of charges | $45.85 | $50.06 | $19.26 – $92.00 |
| 21 | Aetna extended facility · percent of total billed charges · inpatientfrom % of charges | $45.85 | $50.06 | $19.26 – $92.00 |
| 22 | Aetna connected facility · percent of total billed charges · outpatientfrom % of charges | $46.38 | $50.63 | $19.48 – $93.06 |
| 23 | Aetna extended facility · percent of total billed charges · outpatientfrom % of charges | $46.38 | $50.63 | $19.48 – $93.06 |
| 24 | Aetna standard facility · percent of total billed charges · inpatientfrom % of charges | $46.64 | $50.92 | $19.59 – $93.59 |
| 25 | Aetna standard facility · percent of total billed charges · outpatientfrom % of charges | $46.64 | $50.92 | $19.59 – $93.59 |
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.