HCPCS J2004
Injection, lidocaine hcl with epinephrine, 1 mg
Current code36 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $1.04 – $15.06 | $1.00 – $37.65 |
| Deaconess Medical Center | — | $1.03 – $4.87 | $1.01 – $12.17 |
| EvergreenHealth Medical Center | — | $57.60 | $72.00 |
| Highline Medical Center | — | $1.39 – $73.09 | $1.30 – $239 |
| Kadlec Regional Medical Center | — | $34.61 | $49.44 |
| Mary Bridge Children's Hospital | — | $1.20 – $2.38 | $1.01 – $5.93 |
| MultiCare Auburn Medical Center | — | $1.06 – $3.14 | $1.00 – $7.84 |
| MultiCare Covington Medical Center | — | $1.01 – $6.02 | $1.02 – $15.03 |
| MultiCare Good Samaritan Hospital | — | $1.04 – $3.06 | $1.01 – $7.63 |
| MultiCare Valley Hospital | — | $1.03 – $4.87 | $1.01 – $12.17 |
| Olympic Medical Center | — | $35.54 – $57.50 | $44.42 – $71.88 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $70.66 | $101 |
| Providence Centralia Hospital | — | $40.02 – $53.25 | $76.96 – $102 |
| Providence Holy Family Hospital | — | $70.66 | $101 |
| Providence Mount Carmel Hospital | — | $70.66 | $101 |
| Providence Regional Medical Center Everett | — | $37.12 – $42.91 | $71.38 – $82.52 |
| Providence St Joseph Hospital | — | $70.66 | $101 |
| Providence St Mary Medical Center | — | $30.00 | $42.86 |
| Providence St Peter Hospital | — | $39.97 – $47.93 | $76.86 – $92.17 |
| St Anthony Hospital | — | $1.39 – $72.80 | $1.30 – $239 |
| St Clare Hospital | — | $1.32 – $69.00 | $1.30 – $239 |
| St Elizabeth Hospital | $1.36 – $49.55 | $1.61 – $84.58 | $1.30 – $239 |
| St Francis Community Hospital | — | $1.43 – $75.12 | $1.30 – $239 |
| St Joseph Medical Center | — | $1.51 – $79.28 | $1.30 – $239 |
| St Michael Medical Center | — | $1.15 – $106 | $1.30 – $239 |
| Swedish Edmonds Hospital | — | $36.04 | $75.08 |
| Swedish Issaquah | — | $36.04 | $75.08 |
| Swedish Medical Center | — | $36.04 | $75.08 |
| Swedish Medical Center / Cherry Hill | — | $36.04 | $75.08 |
| Tacoma General Allenmore Hospital | — | $1.02 – $10.06 | $1.00 – $25.13 |
| Yakima Valley Memorial | — | $1.07 | $1.00 – $2.67 |
Medicare (traditional) reference
CMS publishes no national amount for this code.