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 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION
Philadelphia, PA
See all hospitals reporting HCPCS J2004 →Price type
Temple Health - Chestnut Hill Hospital’s median price of $1 is 87% below the median hospital's median price ($7), higher than 41% 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: 5 payers, 17 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 Nj indemnity facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 2 | Bcbs Nj managed care facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 3 | Bcbs Nj ppo facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 4 | Bcbs Pa hmo/ppo facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 5 | Bcbs Pa indemnity facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 6 | Bcbs Pa tiered ppaca facility · fee schedule · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 7 | Bcbs Pa medicare advantage hmo/medicare advantage ppo facility · percent of total billed charges · outpatientfrom % of charges | $0.35 | $0.53 | $0.05 – $1.23 |
| 8 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $0.60 | $0.91 | $0.09 – $2.12 |
| 9 | UnitedHealthcare chip facility · percent of total billed charges · outpatientfrom % of charges | $0.72 | $1.10 | $0.11 – $2.57 |
| 10 | UnitedHealthcare community plan facility · percent of total billed charges · outpatientfrom % of charges | $0.72 | $1.10 | $0.11 – $2.57 |
| 11 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $0.99 | $1.50 | $0.15 – $3.50 |
| 12 | UnitedHealthcare vaccn facility · percent of total billed charges · outpatientfrom % of charges | $1.45 | $2.20 | $0.22 – $5.13 |
| 13 | Cigna medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $1.81 | $2.75 | $0.28 – $6.42 |
| 14 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $2.17 | $3.30 | $0.34 – $7.70 |
| 15 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $2.17 | $3.30 | $0.34 – $7.70 |
| 16 | Aetna first health facility · percent of total billed charges · inpatientfrom % of charges | $3.30 | $5.01 | $0.51 – $11.68 |
| 17 | Aetna first health facility · percent of total billed charges · outpatientfrom % of charges | $3.30 | $5.01 | $0.51 – $11.68 |
Last updated: Apr 8, 2026
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