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
Quitman, TX
See all hospitals reporting HCPCS J2004 →Price type
Quitman Hospital, LLC’s median price of $20 is 206% 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: 9 payers, 20 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 blue cross medicare advantage oos [116005] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 2 | Cigna cigna medicare replacement [126500] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 3 | Humana humana medicare advantage/ppo/gold [152503] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 4 | Medicare medicare part a and b [163500] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 5 | Medicare medicare part a only [163502] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 6 | Medicare medicare part b only [163501] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 7 | WellCare wellcare medicare [377501] facility · percent of total billed charges · bothfrom % of charges | $11.63 | $11.04 | $5.72 – $15.73 |
| 8 | Aetna aetna coventry medicare replacement [102002] facility · percent of total billed charges · bothfrom % of charges | $11.86 | $11.26 | $5.84 – $16.04 |
| 9 | UnitedHealthcare uhc medicare advantage [206511] facility · percent of total billed charges · bothfrom % of charges | $11.86 | $11.26 | $5.84 – $16.04 |
| 10 | Ambetter ambetter [293000] facility · percent of total billed charges · bothfrom % of charges | $13.29 | $12.62 | $6.54 – $17.98 |
| 11 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $19.72 | $10.22 – $28.09 |
| 12 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $19.72 | $10.22 – $28.09 |
| 13 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $20.76 | $19.72 | $10.22 – $28.09 |
| 14 | Blue Cross Blue Shield bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges | $27.66 | $26.26 | $13.61 – $37.41 |
| 15 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $27.66 | $26.26 | $13.61 – $37.41 |
| 16 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $27.66 | $26.26 | $13.61 – $37.41 |
| 17 | UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges | $41.53 | $39.43 | $20.44 – $56.18 |
| 18 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $41.53 | $39.43 | $20.44 – $56.18 |
| 19 | UnitedHealthcare united healthcare texas exchange plan [206034] facility · percent of total billed charges · bothfrom % of charges | $41.53 | $39.43 | $20.44 – $56.18 |
| 20 | Cigna cigna ppo [126025] facility · percent of total billed charges · bothfrom % of charges | $47.25 | $44.87 | $23.26 – $63.93 |
Last updated: Feb 12, 2026
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