HCPCS Q9957

Injection, perflutren lipid microspheres, per ml

Current codeContrast Agent41 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS Q9957 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$33.20$83.00
Cascade Valley HospitalArlington$7701 plan$616$770
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$204$509
Highline Medical CenterBurienFile dated 2026-02-28—$36.94 – $185$121 – $605
Island HospitalAnacortes$66.501 plan$133$133
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01———
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01———
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$33.20$83.00
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$33.20$83.00
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$33.20$83.00
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$33.20$83.00
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$204$509
Olympic Medical CenterPort AngelesFile dated 2026-06-24——$1.00
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01—$175 – $354$350 – $709
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$224$320
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$166$320
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$224$320
Providence Regional Medical Center EverettEverettFile dated 2026-04-01———
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$224$320
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$166$320
Skagit Valley HospitalMount Vernon—$476 – $616$595 – $770
St Anthony HospitalGig HarborFile dated 2026-02-28—$36.79 – $184$121 – $605
St Clare HospitalLakewoodFile dated 2026-02-28—$34.87 – $174$121 – $605
St Elizabeth HospitalEnumclawFile dated 2026-02-28$20.57 – $1255 plans$42.74 – $214$121 – $605
St Francis Community HospitalFederal WayFile dated 2026-02-28—$37.96 – $190$121 – $605
St Joseph Medical CenterTacomaFile dated 2026-02-28—$40.06 – $200$121 – $605
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$53.39 – $267$121 – $605
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$153$320
Swedish IssaquahIssaquahFile dated 2026-04-01—$153$320
Swedish Medical CenterSeattleFile dated 2026-04-01—$153$320
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$153$320
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$33.20$83.00
Three Rivers HospitalBrewster$1921 plan$274$274
Trios HealthKennewick——$477
Virginia Mason Medical CenterSeattle—$81.60$160
Yakima Valley MemorialYakimaFile dated 2026-08-27—$36.30 – $124$90.75 – $311

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.