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
Murray, UT
See all hospitals reporting HCPCS J2004 →Price type
IHC Health Services Inc., DBA Intermountain Health Intermountain Medical Center’s median price of $34 is 422% above the median hospital's median price ($7), higher than 81% 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: 5 payers, 25 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 | Regence valuecare cardiac facility · percent of total billed charges · outpatientfrom % of charges | $31.55 | $34.37 | $16.00 – $67.06 |
| 2 | UnitedHealthcare charter ut facility · percent of total billed charges · inpatientfrom % of charges | $34.92 | $38.05 | $17.71 – $74.23 |
| 3 | UnitedHealthcare charter ut facility · percent of total billed charges · outpatientfrom % of charges | $34.92 | $38.05 | $17.71 – $74.23 |
| 4 | Regence blueoption facility · percent of total billed charges · inpatientfrom % of charges | $35.94 | $39.16 | $18.23 – $76.40 |
| 5 | Regence blueoption facility · percent of total billed charges · outpatientfrom % of charges | $35.94 | $39.16 | $18.23 – $76.40 |
| 6 | Regence cardiac care facility · percent of total billed charges · inpatientfrom % of charges | $35.94 | $39.16 | $18.23 – $76.40 |
| 7 | Regence cardiac care facility · percent of total billed charges · outpatientfrom % of charges | $35.94 | $39.16 | $18.23 – $76.40 |
| 8 | Regence high performance facility · percent of total billed charges · inpatientfrom % of charges | $40.74 | $44.39 | $20.66 – $86.60 |
| 9 | Regence valuecare cardiac facility · percent of total billed charges · inpatientfrom % of charges | $40.74 | $44.39 | $20.66 – $86.60 |
| 10 | Regence fehbp facility · percent of total billed charges · inpatientfrom % of charges | $41.03 | $44.71 | $20.81 – $87.22 |
| 11 | Regence fehbp facility · percent of total billed charges · outpatientfrom % of charges | $41.03 | $44.71 | $20.81 – $87.22 |
| 12 | UnitedHealthcare non-options ppo facility · percent of total billed charges · inpatientfrom % of charges | $41.32 | $45.03 | $20.96 – $87.84 |
| 13 | UnitedHealthcare non-options ppo facility · percent of total billed charges · outpatientfrom % of charges | $41.32 | $45.03 | $20.96 – $87.84 |
| 14 | Regence traditional facility · percent of total billed charges · inpatientfrom % of charges | $44.23 | $48.20 | $22.44 – $94.03 |
| 15 | Regence traditional facility · percent of total billed charges · outpatientfrom % of charges | $44.23 | $48.20 | $22.44 – $94.03 |
| 16 | Aetna connected facility · percent of total billed charges · inpatientfrom % of charges | $46.56 | $50.74 | $23.62 – $98.98 |
| 17 | Aetna connected facility · percent of total billed charges · outpatientfrom % of charges | $47.14 | $51.37 | $23.91 – $100.21 |
| 18 | Molina chip facility · percent of total billed charges · inpatientfrom % of charges | $47.73 | $52.01 | $24.21 – $101.45 |
| 19 | Molina chip facility · percent of total billed charges · outpatientfrom % of charges | $47.73 | $52.01 | $24.21 – $101.45 |
| 20 | Aetna extended facility · percent of total billed charges · inpatientfrom % of charges | $49.47 | $53.91 | $25.09 – $105.16 |
| 21 | Aetna extended facility · percent of total billed charges · outpatientfrom % of charges | $49.47 | $53.91 | $25.09 – $105.16 |
| 22 | Cigna ppo/epo facility · percent of total billed charges · inpatientfrom % of charges | $49.47 | $53.91 | $25.09 – $105.16 |
| 23 | Cigna ppo/epo facility · percent of total billed charges · outpatientfrom % of charges | $49.47 | $53.91 | $25.09 – $105.16 |
| 24 | UnitedHealthcare options ppo facility · percent of total billed charges · inpatientfrom % of charges | $49.47 | $53.91 | $25.09 – $105.16 |
| 25 | UnitedHealthcare options ppo facility · percent of total billed charges · outpatientfrom % of charges | $49.47 | $53.91 | $25.09 – $105.16 |
Last updated: Aug 5, 2026
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