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
Healdton, OK
See all hospitals reporting HCPCS J2004 →Price type
Mercy Hospital Healdton Inc’s median price of $17 is 166% above the median hospital's median price ($7), higher than 67% 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: 17 payers, 36 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 | Aetna hb hmh ok medicaid (soonercare) facility · fee schedule · outpatient | $8.00 | $8.00 | $8.00 – $8.00 |
| 2 | Humana hb hmh ok medicaid (soonercare) facility · fee schedule · outpatient | $8.00 | $8.00 | $8.00 – $8.00 |
| 3 | Medicaid hb hmh ok medicaid (soonercare) facility · fee schedule · outpatient | $8.00 | $8.00 | $8.00 – $8.00 |
| 4 | Aetna hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 5 | Blue Cross Blue Shield hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 6 | First Health hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 7 | Humana hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 8 | Medica hb hmh medica medicare w/seq new 031523 facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 9 | Medicare hb hmh medicare facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 10 | Tricare hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 11 | Tricare hb hmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 12 | UnitedHealthcare hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 13 | WellCare hb hmh managed medicare 100% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $11.70 | $11.70 | $11.70 – $11.70 |
| 14 | Cigna hb hmh cigna mcr 103% facility · percent of total billed charges · outpatientfrom % of charges | $12.05 | $12.05 | $12.05 – $12.05 |
| 15 | Blue Cross Blue Shield hb hmh bcbs of ok nativeblue mcr 103% (no seq) facility · percent of total billed charges · outpatientfrom % of charges | $12.29 | $12.29 | $12.29 – $12.29 |
| 16 | Devoted hb hmh devoted health mcr 104% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $12.41 | $12.41 | $12.41 – $12.41 |
| 17 | Ambetter hb hmh ambetter exchange medicare facility · percent of total billed charges · outpatientfrom % of charges | $12.78 | $12.78 | $12.78 – $12.78 |
| 18 | UnitedHealthcare hb hmh uhc medicare new 040122 w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $13.79 | $13.79 | $13.79 – $13.79 |
| 19 | Blue Cross Blue Shield hb hmh blue cross preferred facility · percent of total billed charges · outpatientfrom % of charges | $15.76 | $15.76 | $15.76 – $15.76 |
| 20 | Blue Cross Blue Shield hb hmh blue lincs facility · percent of total billed charges · outpatientfrom % of charges | $15.76 | $15.76 | $15.76 – $15.76 |
| 21 | Blue Cross Blue Shield hb hmh blue cross advantage ppo facility · percent of total billed charges · outpatientfrom % of charges | $16.19 | $16.19 | $16.19 – $16.19 |
| 22 | Medica hb hmh medica exchange 136% mcr no seq facility · percent of total billed charges · outpatientfrom % of charges | $16.22 | $16.22 | $16.22 – $16.22 |
| 23 | Anthem hb hmh blue choice ppo facility · percent of total billed charges · outpatientfrom % of charges | $17.47 | $17.47 | $17.47 – $17.47 |
| 24 | Blue Cross Blue Shield hb hmh blue choice ppo facility · percent of total billed charges · outpatientfrom % of charges | $17.47 | $17.47 | $17.47 – $17.47 |
| 25 | Blue Cross Blue Shield hb hmh blue traditional facility · percent of total billed charges · outpatientfrom % of charges | $17.89 | $17.89 | $17.89 – $17.89 |
Last updated: Jun 12, 2026
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