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 1 %-1:100000 SOLN 20 ML VIAL per 1 mg
DECATUR, IL
See all hospitals reporting HCPCS J2004 →Price type
St Marys Hospital Decatur Of Hospital Sisters Of The Third Order Of St Francis’s median price of $1 is 91% below the median hospital's median price ($7), higher than 38% 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: 7 payers, 12 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 all commercial cigna fee schedule · both | $0.02 | $0.02 | $0.02 – $0.02 |
| 2 | UnitedHealthcare all commercial united healthcare fee schedule · both | $0.07 | $0.07 | $0.07 – $0.07 |
| 3 | Aetna all commercial aetna percent of total billed charges · bothfrom % of charges | $0.28 | $0.24 | $0.06 – $0.42 |
| 4 | Aetna aetna hshs percent of total billed charges · bothfrom % of charges | $0.42 | $0.36 | $0.09 – $0.63 |
| 5 | First Health all commercial first health network percent of total billed charges · bothfrom % of charges | $0.56 | $0.48 | $0.13 – $0.85 |
| 6 | Cigna cigna behavioral health percent of total billed charges · bothfrom % of charges | $0.61 | $0.52 | $0.14 – $0.92 |
| 7 | MultiPlan all commercial multiplan percent of total billed charges · bothfrom % of charges | $0.61 | $0.52 | $0.14 – $0.92 |
| 8 | UnitedHealthcare uhc medicaid percent of total billed charges · bothfrom % of charges | $0.76 | $0.65 | $0.17 – $1.15 |
| 9 | UnitedHealthcare united healthcare behavioral health percent of total billed charges · bothfrom % of charges | $0.76 | $0.65 | $0.17 – $1.15 |
| 10 | Bcbs Il bcbs of illinois ppo percent of total billed charges · bothfrom % of charges | $81.80 | $81.80 | $81.80 – $81.80 |
| 11 | Bcbs Il bcbs il blue choice plans percent of total billed charges · bothfrom % of charges | $93.05 | $93.05 | $93.05 – $93.05 |
| 12 | Blue Cross Blue Shield blue cross blue shield il hmo sihca percent of total billed charges · bothfrom % of charges | $145.35 | $145.35 | $145.35 – $145.35 |
Last updated: Mar 25, 2026
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