Code: Q9967

Description:
Description: Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
LOCM 300-399 IC 30ML
OMNIPAQUE PO 350 100ML
LOCM 300-399 IC 1ML
LOCM 300-399 IC 200ML
OMNIPAQUE PO 350 50ML
OMNIPAQUE PO 300 50ML
LOCM 300-399 IC 10ML
LOCM 300-399 IC 100ML
LOCM 300-399 IC 75ML
Related codes:
Code: Q9960
HOCM 200-249 IC 1ML
Code: Q9961
HOCM 250-299 IC 50ML
Code: Q9962
HOCM 300-349 IC 50ML
Code: Q9963
GASTROGRAFN PO 367 120ML
Code: Q9964
HOCM 400 OR MORE IC 1ML
Code: Q9965
LOCM 100-199 IC 1ML
Code: Q9966
LOCM 200-299 IC 50ML
Code: Q9968
METHYL BLUE 100 MG INJ
Code: Q9969
TC99M NON-HEU ADD-ON
Florida
Hospital Address Code Price Last Updated
Adventhealth Ocala 1500 Sw 1St Ave, Ocala Q9967 $1 [source] 3 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q9967 $2 [source] 3 years ago
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q9967 $2 [source] 3 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q9967 $2 [source] 3 years ago
Adventhealth New Smyrna Beach 401 Palmetto St, New Smyrna Beach Q9967 $2 [source] 3 years ago
Florida Hospital Zephyrhills Inc 7050 Gall Blvd, Zephyrhills Q9967 $3 [source] 3 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q9967 $4 [source] 3 years ago
West Boca Medical Center 21644 State Rd. 7, Boca Raton Q9967 $5 [source] 3 years ago
Adventhealth Daytona Beach 301 Memorial Medical Pkwy, Daytona Beach Q9967 $7 [source] 3 years ago
Brandon Regional Hospital 119 Oakfield Dr, Brandon Q9967 $7 [source] 3 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q9967 $7 [source] 3 years ago
Delray Medical Center 5352 Linton Blvd., Delray Beach Q9967 $8 [source] 3 years ago
Hialeah Hospital 651 East 25Th St., Hialeah Q9967 $8 [source] 3 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q9967 $9 [source] 3 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q9967 $11 [source] 3 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q9967 $14 [source] 3 years ago
Good Samaritan Medical Center 1309 North Flagler Dr., West Palm Beach Q9967 $15 [source] 3 years ago
Palmetto General Hospital 2001 West 68Th St., Hialeah Q9967 $21 [source] 3 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q9967 $30 [source] 3 years ago
Palm Beach Gardens Medical Center 3360 Burns Rd., West Palm Beach Q9967 $31 [source] 3 years ago
St. Mary's Medical Center 901 45Th St., West Palm Beach Q9967 $37 [source] 3 years ago
Coral Gables Hospital 3100 Douglas Rd., Miami Q9967 $47 [source] 3 years ago
Florida Medical Center, A Campus Of North Shore 5000 West Oakland Park Blvd., Fort Lauderdale Q9967 $48 [source] 3 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q9967 $70 [source] 3 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q9967 $70 [source] 3 years ago
North Shore Medical Center 1100 Northwest 95Th St., Miami Q9967 $72 [source] 3 years ago
Palms Of Pasadena Hospital 1501 Pasadena Ave, Saint Petersburg Q9967 $93 [source] 3 years ago
Englewood Community Hospital 700 Medical Blvd, Englewood Q9967 $107 [source] 3 years ago
Fawcett Memorial Hospital 21298 Olean Blvd, Port Charlotte Q9967 $109 [source] 3 years ago
Putnam Community Medical Center 611 Zeagler Dr, Palatka Q9967 $120 [source] 3 years ago
Raulerson Hospital 1796 Hwy 441 North, Okeechobee Q9967 $124 [source] 3 years ago
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q9967 $156 [source] 3 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q9967 $158 [source] 3 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q9967 $190 [source] 3 years ago
Northwest Medical Center 2801 North State Rd 7, Pompano Beach Q9967 $207 [source] 3 years ago
Citrus Memorial Hospital 502 W. Highland Blvd, Inverness Q9967 $262 [source] 3 years ago
Jfk Medical Center 5301 S Congress Ave, Lake Worth Q9967 $267 [source] 3 years ago
Jfk Medical Center - North Campus 2201 45Th St, West Palm Beach Q9967 $267 [source] 3 years ago
West Florida Hospital 8383 N Davis Hwy, Pensacola Q9967 $291 [source] 3 years ago
Capital Regional Medical Center 2626 Capital Medical Blvd, Tallahassee Q9967 $307 [source] 3 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q9967 $345 [source] 3 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q9967 $345 [source] 3 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q9967 $345 [source] 3 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q9967 $345 [source] 3 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q9967 $345 [source] 3 years ago
Cleveland Clinic Florida - Weston 2950 Cleveland Clinic Boulevard, Fort Lauderdale Q9967 $351 [source] 3 years ago
Medical Center Of Trinity 9330 State Rd 54, New Port Richey Q9967 $378 [source] 3 years ago
Palms West Hospital 13001 Southern Blvd, Loxahatchee Q9967 $393 [source] 3 years ago
Memorial Hospital Of Tampa 2901 W. Swann Avenue, Tampa Q9967 $412 [source] 3 years ago
Central Florida Regional Hospital 1401 West Seminole Blvd, Sanford Q9967 $460 [source] 3 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q9967 $592 [source] 3 years ago
Poinciana Medical Center 325 Cypress Pkwy, Kissimmee Q9967 $594 [source] 3 years ago
Twin Cities Hospital 2190 Hwy 85 N, Niceville Q9967 $600 [source] 3 years ago
Orange Park Medical Center 2001 Kingsley Avenue, Orange Park Q9967 $612 [source] 3 years ago
St. Petersburg General Hospital 6500 38Th Ave N, Saint Petersburg Q9967 $625 [source] 3 years ago
Kendall Regional Medical Center 11750 Sw 40 St, Miami Q9967 $628 [source] 3 years ago
Osceola Regional Medical Center 700 West Oak St, Kissimmee Q9967 $666 [source] 3 years ago
St. Lucie Medical Center 1800 Se Tiffany Ave, Port Saint Lucie Q9967 $701 [source] 3 years ago
Oak Hill Hospital 11375 Cortez Blvd, Brooksville Q9967 $727 [source] 3 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q9967 $728 [source] 3 years ago
Adventhealth Dade City 13100 Fort King Rd, Dade City Q9967 $773 [source] 3 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q9967 $976 [source] 3 years ago
Memorial Hospital 3625 University Blvd. S, Jacksonville Q9967 $993 [source] 3 years ago
Plantation General Hospital 401 Nw 42 Ave, Fort Lauderdale Q9967 $1,054 [source] 3 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q9967 $1,056 [source] 3 years ago
Fort Walton Beach Medical Center 1000 Mar Walt Dr, Fort Walton Beach Q9967 $1,088 [source] 3 years ago
University Hospital & Medical Center 7201 North University Dr, Fort Lauderdale Q9967 $1,255 [source] 3 years ago
Largo Medical Center 201 14Th St Sw, Largo Q9967 $1,308 [source] 3 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q9967 $1,332 [source] 3 years ago
Highlands Regional Medical Center 3600 South Highlands Ave, Sebring Q9967 $1,481 [source] 3 years ago
Ocala Health 1431 Sw 1St Ave, Ocala Q9967 $1,534 [source] 3 years ago
Lake City Medical Center 340 Nw Commerce Dr, Lake City Q9967 $1,942 [source] 3 years ago
North Florida Regional Medical Center 6500 W Newberry Rd, Gainesville Q9967 $2,075 [source] 3 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q9967 $2,099 [source] 3 years ago
Lawnwood Medical Center & Heart Institute 1700 S 23Rd St, Fort Pierce Q9967 $3,591 [source] 3 years ago
Gulf Coast Regional Medical Center 449 W 23Rd St, Panama City Q9967 $5,239 [source] 3 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.