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-1:200000 (PF)
Wheaton, MN
See all hospitals reporting HCPCS J2004 →Price type
Sanford Wheaton’s median price of $26 is 299% above the median hospital's median price ($7), higher than 74% 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, 26 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 | $7.43 | $7.41 | $7.32 – $7.47 |
| 2 | Sanford Health Plan medicare replacement percent of total billed charges · outpatientfrom % of charges | $15.47 | $15.42 | $15.24 – $15.55 |
| 3 | Ucare medicare replacement percent of total billed charges · outpatientfrom % of charges | $16.60 | $16.55 | $16.36 – $16.69 |
| 4 | Aetna medicare replacement percent of total billed charges · outpatientfrom % of charges | $16.76 | $16.70 | $16.51 – $16.84 |
| 5 | Bcbs Mn medicare replacement percent of total billed charges · outpatientfrom % of charges | $16.76 | $16.70 | $16.51 – $16.84 |
| 6 | UnitedHealthcare medicare replacement percent of total billed charges · outpatientfrom % of charges | $16.76 | $16.70 | $16.51 – $16.84 |
| 7 | Bcbs Nd commercial percent of total billed charges · outpatientfrom % of charges | $21.12 | $21.05 | $20.81 – $21.23 |
| 8 | Sanford Health Plan group health/true percent of total billed charges · inpatientfrom % of charges | $24.23 | $24.15 | $23.87 – $24.35 |
| 9 | Sanford Health Plan group health/true percent of total billed charges · outpatientfrom % of charges | $24.23 | $24.15 | $23.87 – $24.35 |
| 10 | UnitedHealthcare commercial + top 20 percent of total billed charges · inpatientfrom % of charges | $25.63 | $25.55 | $25.25 – $25.76 |
| 11 | UnitedHealthcare commercial + top 20 percent of total billed charges · outpatientfrom % of charges | $25.63 | $25.55 | $25.25 – $25.76 |
| 12 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $26.67 | $26.59 | $26.28 – $26.81 |
| 13 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $26.67 | $26.59 | $26.28 – $26.81 |
| 14 | Ucare commercial percent of total billed charges · inpatientfrom % of charges | $26.96 | $26.88 | $26.57 – $27.10 |
| 15 | Ucare commercial percent of total billed charges · outpatientfrom % of charges | $26.96 | $26.88 | $26.57 – $27.10 |
| 16 | Medica choice percent of total billed charges · outpatientfrom % of charges | $26.98 | $26.89 | $26.58 – $27.12 |
| 17 | Medica choice percent of total billed charges · inpatientfrom % of charges | $27.13 | $27.04 | $26.73 – $27.27 |
| 18 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $27.62 | $27.54 | $27.22 – $27.77 |
| 19 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $27.62 | $27.54 | $27.22 – $27.77 |
| 20 | Bcbs Mn commercial/federal percent of total billed charges · outpatientfrom % of charges | $28.39 | $28.30 | $27.98 – $28.54 |
| 21 | Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · inpatientfrom % of charges | $28.50 | $28.41 | $28.08 – $28.65 |
| 22 | Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · outpatientfrom % of charges | $28.50 | $28.41 | $28.08 – $28.65 |
| 23 | Sanford Health Plan sd exchange true percent of total billed charges · inpatientfrom % of charges | $28.50 | $28.41 | $28.08 – $28.65 |
| 24 | Sanford Health Plan sd exchange true percent of total billed charges · outpatientfrom % of charges | $28.50 | $28.41 | $28.08 – $28.65 |
| 25 | Medica elect percent of total billed charges · outpatientfrom % of charges | $28.85 | $28.76 | $28.43 – $29.00 |
Last updated: Mar 4, 2026
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