Low-osmolar contrast dye, 100-199 iodine, per mL at St.davids Surgical Hospital

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.

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Provider: anthropic
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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

LOCM 100-199 IC 10ML

Austin, TX

See all hospitals reporting HCPCS Q9965 →

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Pricing by billing methodology

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How this price compares nationally

St.davids Surgical Hospital’s median price of $208 is 7311% above the median hospital's median price ($3), higher than 95% of the 1,553 hospitals reporting HCPCS Q9965. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q9965 at St.davids Surgical Hospital

Negotiated rates from the hospital’s own file: 6 payers, 24 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 blueadvantage fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
2	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
3	UnitedHealthcare narrownetworkhix fee schedule · outpatient	$1	$1	—	—	—	$1 – $1
4	Blue Cross Blue Shield blueessentials fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
5	Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
6	Blue Cross Blue Shield eposoa fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
7	Blue Cross Blue Shield ppo fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
8	UnitedHealthcare allpayerappendix fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
9	UnitedHealthcare smallgroup fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
10	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$61	$61	—	—	—	$61 – $61
11	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$61	$61	—	—	—	$61 – $61
12	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$61	$61	—	—	—	$61 – $61
13	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$61	$61	—	—	—	$61 – $61
14	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$208	$208	—	—	—	$208 – $208
15	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$208	$208	—	—	—	$208 – $208
16	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$208	$208	—	—	—	$208 – $208
17	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$305	$305	—	—	—	$305 – $305
18	Humana hmo percent of total billed charges · outpatientfrom % of charges	$340	$340	—	—	—	$340 – $340
19	Humana ppo percent of total billed charges · outpatientfrom % of charges	$340	$340	—	—	—	$340 – $340
20	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$361	$361	—	—	—	$361 – $361
21	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$551	$551	—	—	—	$551 – $551
22	First Health ppo percent of total billed charges · outpatientfrom % of charges	$815	$784	$66	8%	—	$692 – $845
23	MultiPlan phcsprimarynetwork percent of total billed charges · outpatientfrom % of charges	$919	$919	—	—	—	$919 – $919
24	MultiPlan complementarynetwork percent of total billed charges · outpatientfrom % of charges	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k

Last updated: Sep 1, 2026

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