Code: Q9965

Description:

Description: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Other Descriptions:

Contr Locm 100-199mg 1ml

IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION

HC LOCM 100-199 MG/ML IODINE CONCENTRATION PER ML

LOCM 100-199 MG/ML 100ML

LOCM 100-199 MG/ML 150ML

LOCM 100-199 MG/ML 50ML

LOCM 100-199 MG/ML 300ML

1ML PER 1CC OMNIPAQUE CONTRAST AGENT CONCENTRATION 180

IOHEXOL INJ 180 PER ML

Related codes:

Code: Q9960

Description: High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9961

Description: High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9962

Description: High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9963

Description: High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9964

Description: High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9966

Description: Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9967

Description: Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9968

Description: Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)

Code: Q9969

Description: Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose
HCPCS Category: Temporary codes (limited use and guidelines specific)

Massachusetts

Hospital	Address	Code	Price	Last Updated
Saint Vincent Hospital	123 Summer St., Worcester	Q9965	$7 [source]	4 years ago
Metrowest Medical Center - Framingham Union Hospital	115 Lincoln Street, Framingham	Q9965	$12 [source]	4 years ago
Metrowest Medical Center - Leonard Morse Hospital	67 Union Street, Natick	Q9965	$12 [source]	4 years ago
Brigham & Womens Hospital, Inc.	75 Francis St, Boston	Q9965	$37 [source]	4 years ago
North Shore Medical Center Hospital	81 Highland Ave, Salem	Q9965	$56 [source]	4 years ago
Brigham & Women Faulkner Hospital	1153 Centre St, Jamaica Plain	Q9965	$56 [source]	4 years ago
Spaulding Rehab Hospital Boston	300 1St Ave, Charlestown	Q9965	$56 [source]	4 years ago
Newton Wellesley Hospital	2014 Washington St, Newton Lower Falls	Q9965	$56 [source]	4 years ago
Spaulding Rehab Hospital Cape Cod	311 Service Rd, East Sandwich	Q9965	$56 [source]	4 years ago
Massachusetts General Hospital	55 Fruit St, Boston	Q9965	$57 [source]	4 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.