Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
LOCM 300-399 IC 100ML
Kansas City, MO
See all hospitals reporting HCPCS Q9967 →Price type
Belton Regional Medical Center’s median price of $33 is 211% above the median hospital's median price ($11), higher than 58% of the 2,274 hospitals reporting HCPCS Q9967. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 16 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Blue Cross Blue Shield tricare fee schedule · outpatient | $0.14 | $0.14 | $0.14 – $0.14 |
| 2 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $0.25 | $0.25 | $0.25 – $0.25 |
| 3 | Blue Cross Blue Shield freedomnetworkselect percent of total billed charges · outpatientfrom % of charges | $18.48 | $15.97 | $3.39 – $20.36 |
| 4 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $20.17 | $17.43 | $3.70 – $22.22 |
| 5 | Aetna Better Health mcd percent of total billed charges · outpatientfrom % of charges | $24.11 | $20.84 | $4.42 – $26.56 |
| 6 | Blue Cross Blue Shield freedomnetwork percent of total billed charges · outpatientfrom % of charges | $28.93 | $25.01 | $5.31 – $31.87 |
| 7 | Blue Cross Blue Shield pc percent of total billed charges · outpatientfrom % of charges | $28.93 | $25.01 | $5.31 – $31.87 |
| 8 | Aetna familyhealthplanmcd percent of total billed charges · outpatientfrom % of charges | $29.73 | $25.70 | $5.46 – $32.76 |
| 9 | Blue Cross Blue Shield participating percent of total billed charges · outpatientfrom % of charges | $32.95 | $28.48 | $6.05 – $36.30 |
| 10 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $32.95 | $28.48 | $6.05 – $36.30 |
| 11 | Blue Cross Blue Shield blue-care(hmo) percent of total billed charges · outpatientfrom % of charges | $34.55 | $29.87 | $6.34 – $38.07 |
| 12 | Blue Cross Blue Shield blueaccess percent of total billed charges · outpatientfrom % of charges | $34.55 | $29.87 | $6.34 – $38.07 |
| 13 | UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges | $36.16 | $31.26 | $6.64 – $39.84 |
| 14 | Blue Cross Blue Shield preferred-careblue(ppo) percent of total billed charges · outpatientfrom % of charges | $44.20 | $38.20 | $8.11 – $48.69 |
| 15 | MultiPlan complimentarynetwork percent of total billed charges · outpatientfrom % of charges | $59.47 | $51.40 | $10.91 – $65.51 |
| 16 | MultiPlan wcompmissouri percent of total billed charges · outpatientfrom % of charges | $64.29 | $55.57 | $11.80 – $70.82 |
Last updated: Mar 1, 2026
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