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
Michigan
Hospital Address Code Price Last Updated
Aspirus Keweenaw Hospital 205 Osceola Street, Calumet Q9967 $2 [source] 3 years ago
Aspirus Iron River Hospital 1400 W Ice Lake Rd, Iron River Q9967 $2 [source] 3 years ago
Aspirus Ontonagon Hospital 601 S Seventh St, Ontonagon Q9967 $2 [source] 3 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint Q9967 $2 [source] 3 years ago
Mclaren Caro Region 401 N Hooper St, Caro Q9967 $3 [source] 3 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer Q9967 $5 [source] 3 years ago
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q9967 $6 [source] 3 years ago
Mclaren Oakland 50 N Perry St, Pontiac Q9967 $7 [source] 3 years ago
Dmc Huron Valley - Sinai Hospital 1 William Carls Drive, Commerce Township Q9967 $11 [source] 3 years ago
Aspirus Ironwood Hospital N10565 Grandview Ln, Ironwood Q9967 $16 [source] 3 years ago
Mclaren Port Huron 1221 Pine Grove Ave, Port Huron Q9967 $21 [source] 3 years ago
Mclaren Northern Michigan 416 Connable Ave, Petoskey Q9967 $22 [source] 3 years ago
Karmanos Cancer Institute 4100 John R St, Detroit Q9967 $33 [source] 3 years ago
Dmc Children's Hospital Of Michigan 3901 Beaubien Blvd., Detroit Q9967 $56 [source] 3 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak Q9967 $66 [source] 3 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak Q9967 $66 [source] 3 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak Q9967 $66 [source] 3 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak Q9967 $66 [source] 3 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak Q9967 $66 [source] 3 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak Q9967 $66 [source] 3 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak Q9967 $66 [source] 3 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak Q9967 $66 [source] 3 years ago
Dmc Hutzel Women's Hospital 3990 John R Street, Detroit Q9967 $68 [source] 3 years ago
Dmc Detroit Receiving Hospital 4201 St. Antoine Blvd, Detroit Q9967 $75 [source] 3 years ago
Dmc Sinai-Grace Hospital 6071 West Outer Drive, Detroit Q9967 $83 [source] 3 years ago
Up Health System – Marquette 580 West College Avenue, Marquette Q9967 $94 [source] 3 years ago
Botsford Continuing Care Corporation 21450 Archwood Cir, Farmington Q9967 $96 [source] 3 years ago
Botsford General Hospital 28050 Grand River Ave, Farmington Q9967 $96 [source] 3 years ago
Mclaren Thumb Region 1100 S Van Dyke Rd, Bad Axe Q9967 $331 [source] 3 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q9967 $340 [source] 3 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q9967 $447 [source] 3 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q9967 $447 [source] 3 years ago
Midmichigan Medical Center Gratiot 300 E Warwick Dr, Alma Q9967 $450 [source] 3 years ago
Midmichigan Medical Center Gladwin , Gladwin Q9967 $486 [source] 3 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy Q9967 $894 [source] 3 years ago
William Beaumont Hospital 44201 Dequindre, Troy Q9967 $894 [source] 3 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q9967 $894 [source] 3 years ago
Mclaren Greater Lansing 401 W Greenlawn Ave, Lansing Q9967 $902 [source] 3 years ago
Mclaren Central Michigan 1221 South Dr, Mount Pleasant Q9967 $967 [source] 3 years ago
Oakwood Healthcare Inc Beaumont Service Center, Q9967 $1,432 [source] 3 years ago
Oakwood Healthcare, Inc. 33155 Annapolis St, Wayne Q9967 $1,432 [source] 3 years ago
Oakwood Healthcare, Inc. 5450 Fort St, Trenton Q9967 $1,489 [source] 3 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn Q9967 $1,515 [source] 3 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn Q9967 $1,515 [source] 3 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn Q9967 $1,515 [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.