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Every billing code / Imaging / Standard X-ray

HCPCS Q9967

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Current codeContrast Agent56 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

HospitalOther government program rates (lowest – highest)Cash priceList price (before discounts)
Arbor Health Morton HospitalMortonFile dated 2026-05-18—$4.34 – $4.96$7.00 – $8.00
Capital Medical CenterOlympiaFile dated 2026-08-27—$1.00 – $30.16$1.00 – $75.40
Cascade Medical CenterLeavenworth$2.231 plan$2.00$2.50
Cascade Valley HospitalArlington—$75.47 – $336$94.34 – $420
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$1.00 – $26.52$1.00 – $66.28
East Adams Rural HospitalRitzvilleFile dated 2025-08-30$1.82 – $2441 plan$1.53 – $206$2.04 – $274
EvergreenHealth Medical CenterKirkland—$37.60 – $508$47.00 – $635
EvergreenHealth MonroeMonroe—$73.60 – $295$92.00 – $369
Forks Community HospitalForksFile dated 2026-10-27—$1.43 – $1.58$1.78 – $1.98
Grays Harbor Community HospitalAberdeen—$78.66 – $287$121 – $442
Harborview Medical CenterSeattleFile dated 2026-04-01—$902 – $2,160$1,288 – $3,086
Highline Medical CenterBurienFile dated 2026-02-28—$1.42 – $1,579$4.62 – $5,172
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$63.00 – $93.49$90.00 – $134
Kittitas Valley Community HospitalEllensburgFile dated 2026-10-07—$194 – $309$229 – $364
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$9.10 – $32.50$14.00 – $50.00
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$1.02 – $2.10$1.00 – $5.23
Mason General Hospital & Family of ClinicsShelton—$3.38 – $41.63$4.50 – $55.50
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$1.05 – $31.94$1.00 – $79.83
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$1.06 – $30.30$1.00 – $75.75
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$1.05 – $31.94$1.00 – $79.85
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$1.00 – $50.51$1.00 – $126
Olympic Medical CenterPort AngelesFile dated 2026-06-24——$1.00
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$63.00 – $435$90.00 – $621
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$46.80$90.00
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$63.00 – $435$90.00 – $621
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$63.00 – $112$90.00 – $161
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$46.80 – $115$90.00 – $221
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$63.00 – $112$90.00 – $161
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$63.00 – $101$90.00 – $144
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$46.80$90.00
Quincy Valley Medical CenterQuincyFile dated 2026-05-27—$234 – $274$234 – $274
Seattle Children's HospitalSeattle$28.80 – $4761 plan$70.25 – $1,160$70.25 – $1,160
Skagit Valley HospitalMount Vernon—$4.80 – $430$6.00 – $537
Skyline HospitalWhite SalmonFile dated 2026-08-21$3.31 – $6.121 plan$3.31 – $6.12$4.60 – $8.50
St Anthony HospitalGig HarborFile dated 2026-02-28—$1.41 – $1,573$4.62 – $5,172
St Clare HospitalLakewoodFile dated 2026-02-28—$1.34 – $1,491$4.62 – $5,172
St Elizabeth HospitalEnumclawFile dated 2026-02-28—$1.64 – $1,828$4.62 – $5,172
St Francis Community HospitalFederal WayFile dated 2026-02-28—$1.45 – $1,623$4.62 – $5,172
St Joseph Medical CenterTacomaFile dated 2026-02-28—$1.54 – $1,713$4.62 – $5,172
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$2.04 – $2,283$4.62 – $5,172
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$43.20 – $273$90.00 – $569
Swedish IssaquahIssaquahFile dated 2026-04-01—$43.20$1.00 – $90.00
Swedish Medical CenterSeattleFile dated 2026-04-01—$43.20 – $69.34$1.00 – $144
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$43.20$1.00 – $90.00
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$1.00 – $31.92$1.00 – $79.80
Three Rivers HospitalBrewster—$1.89 – $6.36$1.89 – $6.36
Trios HealthKennewick——$6.26
University of Washington Medical CtrSeattleFile dated 2026-04-01—$787 – $1,900$1,124 – $2,714
Virginia Mason Medical CenterSeattle—$1.02 – $4.08$1.00 – $8.00
WhidbeyHealth Medical CenterCoupeville—$700 – $1,248$700 – $1,248
Yakima Valley MemorialYakimaFile dated 2026-08-27—$1.00 – $30.20$1.01 – $75.50

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.