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
Kansas
Hospital Address Code Price Last Updated
Saint Luke’s South Hospital 12300 Metcalf Ave, Shawnee Mission Q9967 $3 [source] 3 years ago
Ascension Via Christi Hospital Manhattan, Inc. 1823 College Ave, Manhattan Q9967 $5 [source] 3 years ago
Mt. Carmel Regional Medical Center, Inc. 1 Mt Carmel Way, Pittsburg Q9967 $5 [source] 3 years ago
Community Hospital Onaga - Technician Services 120 W. 8Th St., Onaga Q9967 $9 [source] 3 years ago
Adventhealth Ransom Memorial, Inc. 1301 S Main St , Ottawa Q9967 $10 [source] 3 years ago
Menorah Medical Center 5721 W. 119Th Street, Shawnee Mission Q9967 $460 [source] 3 years ago
Western Plains Medical Complex 3001 Avenue A, Dodge City Q9967 $750 [source] 3 years ago
Overland Park Regional Medical Center 10500 Quivira Road, Shawnee Mission Q9967 $1,316 [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 §180.