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
Cassville, MO
See all hospitals reporting HCPCS J2004 →Price type
Mercy Hospital Cassville’s median price of $21 is 219% above the median hospital's median price ($7), higher than 70% 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: 16 payers, 33 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 casv mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $5.25 | $5.25 | $5.21 – $5.28 |
| 2 | UnitedHealthcare hb casv uhc mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $5.25 | $5.25 | $5.21 – $5.28 |
| 3 | Blue Cross Blue Shield hb casv mtnv ar bc facility · fee schedule · outpatient | $9.00 | $9.00 | $6.00 – $12.00 |
| 4 | Aetna hb casv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 5 | Blue Cross Blue Shield hb casv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 6 | Blue Cross Blue Shield hb casv medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 7 | Cigna hb casv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 8 | Humana hb casv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 9 | Medica hb casv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 10 | Medicare hb casv medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 11 | UnitedHealthcare hb casv medicare facility · percent of total billed charges · outpatientfrom % of charges | $10.04 | $10.04 | $9.96 – $10.11 |
| 12 | UnitedHealthcare hb casv uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $10.30 | $10.30 | $10.22 – $10.37 |
| 13 | Devoted hb casv devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $10.44 | $10.44 | $10.36 – $10.51 |
| 14 | WellCare hb casv wellcare medicare 103% facility · percent of total billed charges · outpatientfrom % of charges | $10.61 | $10.61 | $10.53 – $10.68 |
| 15 | Tricare hb casv tricare facility · percent of total billed charges · outpatientfrom % of charges | $10.63 | $10.63 | $10.55 – $10.71 |
| 16 | Blue Cross Blue Shield hb casv mo care/healthy blue facility · percent of total billed charges · outpatientfrom % of charges | $11.16 | $11.16 | $11.08 – $11.24 |
| 17 | Ambetter hb casv ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges | $13.64 | $13.64 | $13.54 – $13.74 |
| 18 | Blue Cross Blue Shield hb casv anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $19.15 | $19.15 | $19.01 – $19.29 |
| 19 | Blue Cross Blue Shield hb casv anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $19.94 | $19.94 | $19.79 – $20.08 |
| 20 | Optum hb casv uhc all payor facility · percent of total billed charges · outpatientfrom % of charges | $20.99 | $20.99 | $20.83 – $21.14 |
| 21 | UnitedHealthcare hb casv uhc all payor facility · percent of total billed charges · outpatientfrom % of charges | $20.99 | $20.99 | $20.83 – $21.14 |
| 22 | UnitedHealthcare hb casv uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $20.99 | $20.99 | $20.83 – $21.14 |
| 23 | Humana hb casv humana commercial facility · percent of total billed charges · outpatientfrom % of charges | $22.30 | $22.30 | $22.13 – $22.46 |
| 24 | Blue Cross Blue Shield hb casv anthem pathway exchange facility · percent of total billed charges · outpatientfrom % of charges | $23.09 | $23.09 | $22.92 – $23.25 |
| 25 | Aetna hb casv aetna facility · percent of total billed charges · outpatientfrom % of charges | $23.35 | $23.35 | $23.18 – $23.51 |
Last updated: Jun 10, 2026
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