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 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION
Salt Lake City, UT
See all hospitals reporting HCPCS J2004 →Price type
IHC Health Services Inc., DBA Intermountain Health LDS Hospital’s median price of $34 is 412% above the median hospital's median price ($7), higher than 80% 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 | UnitedHealthcare charter facility · percent of total billed charges · inpatientfrom % of charges | $33.48 | $29.20 | $8.57 – $41.04 |
| 2 | UnitedHealthcare charter facility · percent of total billed charges · outpatientfrom % of charges | $33.48 | $29.20 | $8.57 – $41.04 |
| 3 | UnitedHealthcare charter ut facility · percent of total billed charges · inpatientfrom % of charges | $33.48 | $29.20 | $8.57 – $41.04 |
| 4 | UnitedHealthcare charter ut facility · percent of total billed charges · outpatientfrom % of charges | $33.48 | $29.20 | $8.57 – $41.04 |
| 5 | Regence blueoption facility · percent of total billed charges · inpatientfrom % of charges | $34.46 | $30.05 | $8.82 – $42.24 |
| 6 | Regence blueoption facility · percent of total billed charges · outpatientfrom % of charges | $34.46 | $30.05 | $8.82 – $42.24 |
| 7 | Cigna open access flex facility · percent of total billed charges · inpatientfrom % of charges | $35.15 | $30.66 | $9.00 – $43.09 |
| 8 | Cigna open access flex facility · percent of total billed charges · outpatientfrom % of charges | $35.15 | $30.66 | $9.00 – $43.09 |
| 9 | Regence high performance facility · percent of total billed charges · inpatientfrom % of charges | $39.06 | $34.07 | $10.00 – $47.88 |
| 10 | Regence fehbp facility · percent of total billed charges · inpatientfrom % of charges | $39.34 | $34.31 | $10.07 – $48.22 |
| 11 | Regence fehbp facility · percent of total billed charges · outpatientfrom % of charges | $39.34 | $34.31 | $10.07 – $48.22 |
| 12 | UnitedHealthcare non-options ppo facility · percent of total billed charges · inpatientfrom % of charges | $39.62 | $34.55 | $10.14 – $48.56 |
| 13 | UnitedHealthcare non-options ppo facility · percent of total billed charges · outpatientfrom % of charges | $39.62 | $34.55 | $10.14 – $48.56 |
| 14 | Regence traditional facility · percent of total billed charges · inpatientfrom % of charges | $42.41 | $36.99 | $10.85 – $51.98 |
| 15 | Regence traditional facility · percent of total billed charges · outpatientfrom % of charges | $42.41 | $36.99 | $10.85 – $51.98 |
| 16 | Aetna connected facility · percent of total billed charges · inpatientfrom % of charges | $44.64 | $38.93 | $11.42 – $54.72 |
| 17 | Aetna connected facility · percent of total billed charges · outpatientfrom % of charges | $45.20 | $39.42 | $11.57 – $55.40 |
| 18 | Molina chip facility · percent of total billed charges · inpatientfrom % of charges | $45.76 | $39.91 | $11.71 – $56.09 |
| 19 | Molina chip facility · percent of total billed charges · outpatientfrom % of charges | $45.76 | $39.91 | $11.71 – $56.09 |
| 20 | Aetna extended facility · percent of total billed charges · inpatientfrom % of charges | $47.43 | $41.37 | $12.14 – $58.14 |
| 21 | Aetna extended facility · percent of total billed charges · outpatientfrom % of charges | $47.43 | $41.37 | $12.14 – $58.14 |
| 22 | Cigna ppo/epo facility · percent of total billed charges · inpatientfrom % of charges | $47.43 | $41.37 | $12.14 – $58.14 |
| 23 | Cigna ppo/epo facility · percent of total billed charges · outpatientfrom % of charges | $47.43 | $41.37 | $12.14 – $58.14 |
| 24 | UnitedHealthcare options ppo facility · percent of total billed charges · inpatientfrom % of charges | $47.43 | $41.37 | $12.14 – $58.14 |
| 25 | UnitedHealthcare options ppo facility · percent of total billed charges · outpatientfrom % of charges | $47.43 | $41.37 | $12.14 – $58.14 |
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.