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
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: Q9966
LOCM 200-299 IC 50ML
Code: Q9967
LOCM 300-399 IC 50ML
Code: Q9968
METHYL BLUE 100 MG INJ
Code: Q9969
TC99M NON-HEU ADD-ON
Florida
Hospital Address Code Price Last Updated
Palms Of Pasadena Hospital 1501 Pasadena Ave, Saint Petersburg Q9965 $1 [source] 3 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q9965 $1 [source] 3 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q9965 $2 [source] 3 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q9965 $2 [source] 3 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q9965 $3 [source] 3 years ago
Adventhealth Zephyrhills 7050 Gall Blvd, Zephyrhills Q9965 $3 [source] 3 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q9965 $3 [source] 3 years ago
Adventhealth Dade City 13100 Fort King Rd, Dade City Q9965 $3 [source] 3 years ago
Florida Hospital Carrollwood 7171 N Dale Mabry Hwy, Tampa Q9965 $3 [source] 3 years ago
Adventhealth Ocala 1500 Sw 1St Ave, Ocala Q9965 $3 [source] 3 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q9965 $3 [source] 3 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q9965 $3 [source] 3 years ago
Adventhealth Lake Wales 410 South 11Th Street, Lake Wales Q9965 $3 [source] 3 years ago
Adventhealth New Smyrna Beach 401 Palmetto St, New Smyrna Beach Q9965 $3 [source] 3 years ago
Twin Cities Hospital 2190 Hwy 85 N, Niceville Q9965 $4 [source] 3 years ago
Adventist Health System/Sunbelt, Inc. 4001 W Linebaugh Ave, Tampa Q9965 $6 [source] 3 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q9965 $6 [source] 3 years ago
Memorial Hospital 3625 University Blvd. S, Jacksonville Q9965 $6 [source] 3 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q9965 $7 [source] 3 years ago
Adventhealth Daytona Beach 301 Memorial Medical Pkwy, Daytona Beach Q9965 $8 [source] 3 years ago
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q9965 $9 [source] 3 years ago
Capital Regional Medical Center 2626 Capital Medical Blvd, Tallahassee Q9965 $9 [source] 3 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q9965 $12 [source] 3 years ago
Orange Park Medical Center 2001 Kingsley Avenue, Orange Park Q9965 $13 [source] 3 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q9965 $17 [source] 3 years ago
Jfk Medical Center 5301 S Congress Ave, Lake Worth Q9965 $17 [source] 3 years ago
Palms West Hospital 13001 Southern Blvd, Loxahatchee Q9965 $17 [source] 3 years ago
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q9965 $116 [source] 3 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q9965 $126 [source] 3 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q9965 $126 [source] 3 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q9965 $144 [source] 3 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q9965 $178 [source] 3 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q9965 $324 [source] 3 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q9965 $324 [source] 3 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q9965 $324 [source] 3 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q9965 $324 [source] 3 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q9965 $324 [source] 3 years ago
Ocala Health 1431 Sw 1St Ave, Ocala Q9965 $357 [source] 3 years ago
Gulf Coast Regional Medical Center 449 W 23Rd St, Panama City Q9965 $1,262 [source] 3 years ago
Fort Walton Beach Medical Center 1000 Mar Walt Dr, Fort Walton Beach Q9965 $1,632 [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.