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
Troy, MO
See all hospitals reporting HCPCS J2004 →Price type
Mercy Hospital Lincoln’s median price of $20 is 204% above the median hospital's median price ($7), higher than 69% 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, 39 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 | Molina hb wash jefn linc samc molina healthchoice of il medicaid new 040125 facility · percent of total billed charges · outpatientfrom % of charges | $1.85 | $2.89 | $1.82 – $5.00 |
| 2 | Aetna hb wash jefn linc samc aetna better health of il medicaid new 040125 facility · percent of total billed charges · outpatientfrom % of charges | $4.26 | $6.67 | $4.20 – $11.54 |
| 3 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $4.26 | $6.67 | $4.20 – $11.54 |
| 4 | Blue Cross Blue Shield hb linc missouri care health plan/healthy blue facility · percent of total billed charges · outpatientfrom % of charges | $5.68 | $8.89 | $5.60 – $15.39 |
| 5 | Medicaid hb linc mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $5.68 | $8.89 | $5.60 – $15.39 |
| 6 | UnitedHealthcare hb linc uhc managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $5.68 | $8.89 | $5.60 – $15.39 |
| 7 | Tricare hb linc tricare - healthnet west facility · percent of total billed charges · outpatientfrom % of charges | $6.08 | $9.51 | $5.99 – $16.47 |
| 8 | Blue Cross Blue Shield hb linc medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $6.69 | $10.46 | $6.59 – $18.11 |
| 9 | Humana hb linc medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $6.69 | $10.46 | $6.59 – $18.11 |
| 10 | Medica hb linc medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $6.69 | $10.46 | $6.59 – $18.11 |
| 11 | Medicare hb linc medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $6.69 | $10.46 | $6.59 – $18.11 |
| 12 | UnitedHealthcare hb linc medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $6.69 | $10.46 | $6.59 – $18.11 |
| 13 | WellCare hb linc medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $6.69 | $10.46 | $6.59 – $18.11 |
| 14 | Aetna hb linc aetna/coventry mcr w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $6.82 | $10.67 | $6.72 – $18.47 |
| 15 | UnitedHealthcare hb linc uhc mcr w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $6.82 | $10.67 | $6.72 – $18.47 |
| 16 | WellCare hb linc wellcare harmony mcr 103% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $6.89 | $10.78 | $6.79 – $18.66 |
| 17 | Devoted hb linc devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $6.96 | $10.89 | $6.86 – $18.85 |
| 18 | Cigna hb linc cigna managed medicare 100% w/seq new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $7.13 | $11.16 | $7.03 – $19.31 |
| 19 | Optum hb linc uhc hmo ppo all payer facility · fee schedule · outpatient | $15.00 | $15.00 | $10.00 – $20.00 |
| 20 | UnitedHealthcare hb linc uhc compass/exchange facility · fee schedule · outpatient | $15.00 | $15.00 | $10.00 – $20.00 |
| 21 | UnitedHealthcare hb linc uhc core new 100121 facility · fee schedule · outpatient | $15.00 | $15.00 | $10.00 – $20.00 |
| 22 | UnitedHealthcare hb linc uhc hmo ppo all payer facility · fee schedule · outpatient | $15.00 | $15.00 | $10.00 – $20.00 |
| 23 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $11.93 | $18.67 | $11.76 – $32.32 |
| 24 | Ambetter hb linc centene exchange/ambetter eff 090118 facility · percent of total billed charges · outpatientfrom % of charges | $13.04 | $20.40 | $12.85 – $35.32 |
| 25 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $13.49 | $21.11 | $13.30 – $36.55 |
Last updated: Jun 10, 2026
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