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
Layton, UT
See all hospitals reporting HCPCS J2004 →Price type
IHC Health Services Inc., DBA Intermountain Health Layton Hospital’s median price of $29 is 341% above the median hospital's median price ($7), higher than 76% 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.
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| # | ||||
|---|---|---|---|---|
| 1 | UnitedHealthcare charter ut facility · percent of total billed charges · inpatientfrom % of charges | $31.14 | $29.63 | $12.49 – $48.60 |
| 2 | UnitedHealthcare charter ut facility · percent of total billed charges · outpatientfrom % of charges | $31.14 | $29.63 | $12.49 – $48.60 |
| 3 | Regence blueoption facility · percent of total billed charges · inpatientfrom % of charges | $32.05 | $30.49 | $12.86 – $50.02 |
| 4 | Regence blueoption facility · percent of total billed charges · outpatientfrom % of charges | $32.05 | $30.49 | $12.86 – $50.02 |
| 5 | Cigna open access flex facility · percent of total billed charges · inpatientfrom % of charges | $32.70 | $31.11 | $13.12 – $51.03 |
| 6 | Cigna open access flex facility · percent of total billed charges · outpatientfrom % of charges | $32.70 | $31.11 | $13.12 – $51.03 |
| 7 | Regence high performance facility · percent of total billed charges · inpatientfrom % of charges | $36.33 | $34.57 | $14.57 – $56.70 |
| 8 | Regence fehbp facility · percent of total billed charges · inpatientfrom % of charges | $36.59 | $34.81 | $14.68 – $57.10 |
| 9 | Regence fehbp facility · percent of total billed charges · outpatientfrom % of charges | $36.59 | $34.81 | $14.68 – $57.10 |
| 10 | UnitedHealthcare non-options ppo facility · percent of total billed charges · inpatientfrom % of charges | $36.85 | $35.06 | $14.78 – $57.51 |
| 11 | UnitedHealthcare non-options ppo facility · percent of total billed charges · outpatientfrom % of charges | $36.85 | $35.06 | $14.78 – $57.51 |
| 12 | Regence traditional facility · percent of total billed charges · inpatientfrom % of charges | $39.45 | $37.53 | $15.82 – $61.56 |
| 13 | Regence traditional facility · percent of total billed charges · outpatientfrom % of charges | $39.45 | $37.53 | $15.82 – $61.56 |
| 14 | Aetna connected facility · percent of total billed charges · inpatientfrom % of charges | $41.52 | $39.51 | $16.66 – $64.80 |
| 15 | Aetna connected facility · percent of total billed charges · outpatientfrom % of charges | $42.04 | $40.00 | $16.86 – $65.61 |
| 16 | Aetna extended facility · percent of total billed charges · inpatientfrom % of charges | $44.12 | $41.97 | $17.70 – $68.85 |
| 17 | Aetna extended facility · percent of total billed charges · outpatientfrom % of charges | $44.12 | $41.97 | $17.70 – $68.85 |
| 18 | Cigna ppo/epo facility · percent of total billed charges · inpatientfrom % of charges | $44.12 | $41.97 | $17.70 – $68.85 |
| 19 | Cigna ppo/epo facility · percent of total billed charges · outpatientfrom % of charges | $44.12 | $41.97 | $17.70 – $68.85 |
| 20 | UnitedHealthcare options ppo facility · percent of total billed charges · inpatientfrom % of charges | $44.12 | $41.97 | $17.70 – $68.85 |
| 21 | UnitedHealthcare options ppo facility · percent of total billed charges · outpatientfrom % of charges | $44.12 | $41.97 | $17.70 – $68.85 |
Last updated: Aug 5, 2026
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