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 Inj 1% w/ Epinephrine-1:100000
Mayville, ND
See all hospitals reporting HCPCS J2004 →Price type
Sanford Mayville Medical Center’s median price of $6 is 6% below the median hospital's median price ($7), higher than 50% 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: 8 payers, 24 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 | Bcbs Mn pmap percent of total billed charges · outpatientfrom % of charges | $1.82 | $4.24 | $0.42 – $8.62 |
| 2 | Sanford Health Plan medicare replacement percent of total billed charges · outpatientfrom % of charges | $3.71 | $8.65 | $0.86 – $17.59 |
| 3 | Ucare medicare replacement percent of total billed charges · outpatientfrom % of charges | $3.98 | $9.28 | $0.93 – $18.87 |
| 4 | Aetna medicare replacement percent of total billed charges · outpatientfrom % of charges | $4.02 | $9.39 | $0.94 – $19.09 |
| 5 | Bcbs Nd medicare replacement percent of total billed charges · outpatientfrom % of charges | $4.02 | $9.39 | $0.94 – $19.09 |
| 6 | UnitedHealthcare medicare replacement percent of total billed charges · outpatientfrom % of charges | $4.02 | $9.39 | $0.94 – $19.09 |
| 7 | Bcbs Nd commercial percent of total billed charges · outpatientfrom % of charges | $5.08 | $11.87 | $1.19 – $24.14 |
| 8 | Sanford Health Plan group health/true/sd exchange true percent of total billed charges · inpatientfrom % of charges | $5.92 | $13.82 | $1.38 – $28.11 |
| 9 | Sanford Health Plan group health/true/sd exchange true percent of total billed charges · outpatientfrom % of charges | $5.92 | $13.82 | $1.38 – $28.11 |
| 10 | Medica choice percent of total billed charges · inpatientfrom % of charges | $6.19 | $14.45 | $1.44 – $29.38 |
| 11 | Medica choice percent of total billed charges · outpatientfrom % of charges | $6.19 | $14.45 | $1.44 – $29.38 |
| 12 | UnitedHealthcare commercial percent of total billed charges · inpatientfrom % of charges | $6.26 | $14.62 | $1.46 – $29.73 |
| 13 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $6.26 | $14.62 | $1.46 – $29.73 |
| 14 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $6.52 | $15.22 | $1.52 – $30.95 |
| 15 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $6.52 | $15.22 | $1.52 – $30.95 |
| 16 | Ucare commercial percent of total billed charges · inpatientfrom % of charges | $6.59 | $15.39 | $1.54 – $31.29 |
| 17 | Ucare commercial percent of total billed charges · outpatientfrom % of charges | $6.59 | $15.39 | $1.54 – $31.29 |
| 18 | Medica elect percent of total billed charges · inpatientfrom % of charges | $6.62 | $15.44 | $1.54 – $31.41 |
| 19 | Medica elect percent of total billed charges · outpatientfrom % of charges | $6.62 | $15.44 | $1.54 – $31.41 |
| 20 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $6.75 | $15.76 | $1.58 – $32.05 |
| 21 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $6.75 | $15.76 | $1.58 – $32.05 |
| 22 | Bcbs Mn commercial percent of total billed charges · outpatientfrom % of charges | $6.94 | $16.20 | $1.62 – $32.95 |
| 23 | Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · inpatientfrom % of charges | $6.97 | $16.26 | $1.63 – $33.07 |
| 24 | Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · outpatientfrom % of charges | $6.97 | $16.26 | $1.63 – $33.07 |
Last updated: Mar 4, 2026
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