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-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION
View, MO
See all hospitals reporting HCPCS J2004 →Price type
Mercy St. Francis Hospital’s median price of $25 is 276% above the median hospital's median price ($7), higher than 72% 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, 31 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 | Blue Cross Blue Shield hb casv mtnv ar bc facility · fee schedule · outpatient | $7.50 | $7.50 | $6.00 – $9.00 |
| 2 | Medicaid hb mtnv mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $9.76 | $9.76 | $5.21 – $14.31 |
| 3 | UnitedHealthcare hb mtnv uhc mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $9.76 | $9.76 | $5.21 – $14.31 |
| 4 | UnitedHealthcare hb mtnv uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $13.40 | $13.40 | $7.15 – $19.65 |
| 5 | Aetna hb mtnv aetna mcr 100% facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 6 | Blue Cross Blue Shield hb mtnv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 7 | Blue Cross Blue Shield hb mtnv medicare facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 8 | Cigna hb mtnv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 9 | Humana hb mtnv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 10 | Medica hb mtnv managed medicare facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 11 | Medicare hb mtnv medicare facility · percent of total billed charges · outpatientfrom % of charges | $13.42 | $13.42 | $7.16 – $19.68 |
| 12 | WellCare hb mtnv wellcare medicare 103% facility · percent of total billed charges · outpatientfrom % of charges | $13.81 | $13.81 | $7.37 – $20.25 |
| 13 | Devoted hb mtnv devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $13.95 | $13.95 | $7.44 – $20.45 |
| 14 | Tricare hb mtnv tricare facility · percent of total billed charges · outpatientfrom % of charges | $16.60 | $16.60 | $8.86 – $24.34 |
| 15 | Ambetter hb mtnv ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges | $25.33 | $25.33 | $13.51 – $37.14 |
| 16 | Blue Cross Blue Shield hb mtnv mo care/healthy blue facility · percent of total billed charges · outpatientfrom % of charges | $30.07 | $30.07 | $16.04 – $44.09 |
| 17 | Blue Cross Blue Shield hb mtnv anthem pathway exchange facility · percent of total billed charges · outpatientfrom % of charges | $42.95 | $42.95 | $22.92 – $62.98 |
| 18 | Aetna hb mtnv aetna facility · percent of total billed charges · outpatientfrom % of charges | $43.44 | $43.44 | $23.18 – $63.70 |
| 19 | Humana hb mtnv humana commercial facility · percent of total billed charges · outpatientfrom % of charges | $43.93 | $43.93 | $23.44 – $64.41 |
| 20 | Blue Cross Blue Shield hb mtnv anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $44.42 | $44.42 | $23.70 – $65.13 |
| 21 | Optum hb mtnv uhc facility · percent of total billed charges · outpatientfrom % of charges | $45.39 | $45.39 | $24.22 – $66.56 |
| 22 | UnitedHealthcare hb mtnv uhc facility · percent of total billed charges · outpatientfrom % of charges | $45.39 | $45.39 | $24.22 – $66.56 |
| 23 | UnitedHealthcare hb mtnv uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $45.39 | $45.39 | $24.22 – $66.56 |
| 24 | Medica hb mtnv medica exchange facility · percent of total billed charges · outpatientfrom % of charges | $46.12 | $46.12 | $24.61 – $67.63 |
| 25 | Blue Cross Blue Shield hb mtnv anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $46.37 | $46.37 | $24.74 – $67.99 |
Last updated: Jun 10, 2026
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