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
LIDO 300MG/EPI 0.3MG MDV
VIENNA, VA
See all hospitals reporting HCPCS J2004 →Price type
Reston Hospital Center’s median price of $69 is 947% above the median hospital's median price ($7), higher than 93% 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: 4 payers, 9 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 | Cigna hmo fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 2 | Cigna ifp fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 3 | Cigna ppo fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 4 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $0.11 | $0.11 | $0.11 – $0.11 |
| 5 | Aetna mgmcr percent of total billed charges · outpatientfrom % of charges | $24.30 | $20.28 | $5.79 – $29.50 |
| 6 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $45.36 | $37.86 | $10.81 – $55.06 |
| 7 | Carefirst hmo percent of total billed charges · outpatientfrom % of charges | $71.28 | $59.50 | $16.99 – $86.53 |
| 8 | Carefirst rpn percent of total billed charges · outpatientfrom % of charges | $71.28 | $59.50 | $16.99 – $86.53 |
| 9 | UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges | $72.90 | $60.85 | $17.37 – $88.49 |
Last updated: Mar 1, 2026
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