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 University Hospital - Jeanes Campus’s median price of $0 is 93% 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, 20 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 | Highmark commercial facility · percent of total billed charges · outpatientfrom % of charges | $0.08 | $0.08 | $0.08 – $0.08 |
| 7 | Aetna coventry facility · percent of total billed charges · outpatientfrom % of charges | $0.22 | $0.34 | $0.03 – $0.78 |
| 8 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $0.22 | $0.34 | $0.03 – $0.78 |
| 9 | 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 |
| 10 | Bcbs Pa tiered ppaca facility · percent of total billed charges · outpatientfrom % of charges | $0.35 | $0.53 | $0.05 – $1.23 |
| 11 | Cigna medicare dsnp/medicare hmo/medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $0.40 | $0.61 | $0.06 – $1.42 |
| 12 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $0.45 | $0.68 | $0.07 – $1.58 |
| 13 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $0.45 | $0.68 | $0.07 – $1.58 |
| 14 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $0.50 | $0.75 | $0.08 – $1.74 |
| 15 | Oscar pennsylvania health plan facility · percent of total billed charges · outpatientfrom % of charges | $0.62 | $0.94 | $0.10 – $2.18 |
| 16 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $0.98 | $1.48 | $0.15 – $3.45 |
| 17 | Aetna first health facility · percent of total billed charges · outpatientfrom % of charges | $0.98 | $1.48 | $0.15 – $3.45 |
| 18 | Aetna workers' comp facility · percent of total billed charges · outpatientfrom % of charges | $0.98 | $1.48 | $0.15 – $3.45 |
| 19 | UnitedHealthcare options ppo facility · percent of total billed charges · inpatientfrom % of charges | $1.23 | $1.87 | $0.19 – $4.36 |
| 20 | UnitedHealthcare options ppo facility · percent of total billed charges · outpatientfrom % of charges | $1.23 | $1.87 | $0.19 – $4.36 |
Last updated: Apr 13, 2026
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