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
Berryville, AR
See all hospitals reporting HCPCS J2004 →Price type
Mercy Hospital Berryville’s median price of $16 is 138% above the median hospital's median price ($7), higher than 65% 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: 15 payers, 23 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 | Medicaid hb bryv ok medicaid facility · fee schedule · outpatient | $5.00 | $5.00 | $2.00 – $8.00 |
| 2 | Anthem hb bryv blue cross facility · fee schedule · outpatient | $7.50 | $7.50 | $3.00 – $12.00 |
| 3 | Blue Cross Blue Shield hb bryv blue cross facility · fee schedule · outpatient | $7.50 | $7.50 | $3.00 – $12.00 |
| 4 | Blue Cross Blue Shield hb bryv healthy blue mo mcd facility · percent of total billed charges · outpatientfrom % of charges | $8.09 | $8.54 | $3.68 – $14.31 |
| 5 | Medicaid hb bryv mo mcd facility · percent of total billed charges · outpatientfrom % of charges | $8.09 | $8.54 | $3.68 – $14.31 |
| 6 | UnitedHealthcare hb bryv uhc mo mcd facility · percent of total billed charges · outpatientfrom % of charges | $8.09 | $8.54 | $3.68 – $14.31 |
| 7 | Tricare hb bryv tricare facility · percent of total billed charges · outpatientfrom % of charges | $10.52 | $11.11 | $4.79 – $18.61 |
| 8 | Aetna hb bryv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 9 | Blue Cross Blue Shield hb bryv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 10 | First Health hb bryv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 11 | Humana hb bryv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 12 | Medica hb bryv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 13 | Medicare hb bryv medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 14 | UnitedHealthcare hb bryv uhc 100% medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 15 | WellCare hb bryv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.51 | $12.15 | $5.24 – $20.36 |
| 16 | WellCare hb bryv allwell 103% mcr hmo facility · percent of total billed charges · outpatientfrom % of charges | $11.85 | $12.52 | $5.40 – $20.97 |
| 17 | Devoted hb bryv devoted mcr facility · percent of total billed charges · outpatientfrom % of charges | $11.97 | $12.64 | $5.45 – $21.18 |
| 18 | Cigna hb bryv healthsprings cigna mcr 105% facility · percent of total billed charges · outpatientfrom % of charges | $12.08 | $12.76 | $5.50 – $21.38 |
| 19 | Ambetter hb bryv ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges | $15.67 | $16.55 | $7.14 – $27.73 |
| 20 | Medica hb aura bryv medica exchange facility · percent of total billed charges · outpatientfrom % of charges | $34.21 | $36.14 | $15.58 – $60.55 |
| 21 | First Health hb bryv coventry health care inc-first health leased facility · percent of total billed charges · outpatientfrom % of charges | $34.38 | $36.31 | $15.66 – $60.83 |
| 22 | Humana hb bryv humana commercial facility · percent of total billed charges · outpatientfrom % of charges | $34.38 | $36.31 | $15.66 – $60.83 |
| 23 | MultiPlan hb bryv phcs (mpi) facility · percent of total billed charges · outpatientfrom % of charges | $38.42 | $40.58 | $17.50 – $67.99 |
Last updated: Jun 4, 2026
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