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
Minnesota
Hospital Address Code Price Last Updated
Essentia Health-Virginia 901 9Th St N, Virginia Q9967 $1 [source] 3 years ago
Essentia Health-Fosston 900 Hilligoss Blvd Se, Fosston Q9967 $3 [source] 3 years ago
Essentia Health-St. Joseph's Medical Center (Brainerd) 523 N 3Rd St, Brainerd Q9967 $3 [source] 3 years ago
Essentia Health-Duluth (Miller-Dwan Building) 502 E 2Nd St, Duluth Q9967 $3 [source] 3 years ago
Essentia Health-Sandstone 705 Lundorff Dr, Sandstone Q9967 $3 [source] 3 years ago
Essentia Health-St. Mary's Medical Center 407 E 3Rd St, Duluth Q9967 $3 [source] 3 years ago
Essentia Health-Northern Pines 5211 Hwy 110, Aurora Q9967 $3 [source] 3 years ago
Essentia Health-Ada 201 9Th St W, Ada Q9967 $3 [source] 3 years ago
Essentia Health St. Mary's-Detroit Lakes 1027 Washington Ave, Detroit Lakes Q9967 $3 [source] 3 years ago
Essentia Health-Holy Trinity Hospital (Graceville) 115 W 2Nd St, Graceville Q9967 $3 [source] 3 years ago
Essentia Health-Deer River 115 10Th Ave Ne, Deer River Q9967 $3 [source] 3 years ago
Essentia Health-Moose Lake 4572 County Road 61, Moose Lake Q9967 $183 [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.