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
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: Q9965
Description: Low osmolar contrast material, 100-199 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: 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)
Idaho
Hospital Address Code Price Last Updated
St. Joseph Regional Medical Center 415 6Th St, Lewiston Q9967 $2 [source] 4 years ago
St. Joseph Regional Medical Center 415 Sixth Street, Lewiston Q9967 $2 [source] 4 years ago
Kootenai Health 2003 Kootenai Health Way, Coeur D Alene Q9967 $3 [source] 4 years ago
North Canyon Medical Center 267 North Canyon Drive, Gooding Q9967 $5 [source] 4 years ago
Lost Rivers Medical Center 551 Highland Dr, Arco Q9967 $21 [source] 4 years ago
Shoshone Medical Center 25 Jacobs Gulch Rd, Kellogg Q9967 $42 [source] 4 years ago
West Valley Medical Center 1717 Arlington Ave., Caldwell Q9967 $59 [source] 4 years ago
Eastern Idaho Regional Medical Center 3100 Channing Way, Idaho Falls Q9967 $62 [source] 4 years ago
Boundary Community Hospital 6640 Kaniksu St, Bonners Ferry Q9967 $263 [source] 4 years ago
West Valley Medical Center 3720 S Indiana Ave, Caldwell Q9967 $306 [source] 4 years ago
Bear Lake Memorial Hospital 164 S 5Th St, Montpelier Q9967 $313 [source] 4 years ago
Minidoka Medical Center 1308 8Th St, Suite 1, Rupert Q9967 $328 [source] 4 years ago
Power County Hospital 510 Roosevelt St, American Falls Q9967 $379 [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 ยง180.