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
Nebraska
Hospital Address Code Price Last Updated
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln Q9967 $195 [source] 3 years ago
Chi Health Good Samaritan 10 E 31St St, Kearney Q9967 $195 [source] 3 years ago
Chi Health Lakeside 17201 Wright St, Omaha Q9967 $195 [source] 3 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler Q9967 $195 [source] 3 years ago
Chi Health Midlands 11111 S 84Th St, Papillion Q9967 $195 [source] 3 years ago
Chi Health Plainview 704 N 3Rd St, Plainview Q9967 $195 [source] 3 years ago
Chi Health St. Mary 1301 Grundman Blvd, Nebraska City Q9967 $195 [source] 3 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha Q9967 $195 [source] 3 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha Q9967 $195 [source] 3 years ago
Chi Health St. Francis 2116 W Faidley Ave, Grand Island Q9967 $195 [source] 3 years ago
Chi Health Nebraska Heart 7500 So. 91St St., Lincoln Q9967 $195 [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.