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Internal Mammary Artery Dye X-Ray

New Hampshire rates for HCPCS 75756

X-ray imaging of the internal mammary artery, the vessel running down the inside of the front of the chest, after a thin tube is guided into it and contrast dye is injected. It is most often done to check this artery before it is used as a bypass graft for the heart, or to check the graft afterwards.

Rates data updated October 2026.

How much does Internal Mammary Artery Dye X-Ray cost?

$263

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $263 for this service. Most negotiated rates run $219 to $417.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $955 · 10th to 90th $603 to $14,454Professionalmedian $251 · 10th to 90th $182 to $589
$200$500$1K$2K$5K$10Kfacility $955professional $251

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$131.83
Median
$245.47
Typical High
$251.19
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$41.69
Median
$61.66
Typical High
$72.44
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$91.20
Median
$181.97
Typical High
$181.97
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$1,023.29
Typical High
$1,047.13
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$165.96
Median
$239.88
Typical High
$436.52
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$53.70
Median
$77.62
Typical High
$138.04
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$112.20
Median
$162.18
Typical High
$269.15
Cigna
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$954.99
Typical High
$17,782.79
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$204.17
Median
$245.47
Typical High
$616.60
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$66.07
Median
$77.62
Typical High
$158.49
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$138.04
Median
$165.96
Typical High
$467.74
Harvard Pilgrim
Setting
Professional
Modifier
None (both parts)
Typical Low
$181.97
Median
$302.00
Typical High
$630.96
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$58.88
Median
$91.20
Typical High
$173.78
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$123.03
Median
$204.17
Typical High
$398.11
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$204.17
Median
$269.15
Typical High
$575.44
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$63.10
Median
$75.86
Typical High
$147.91
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$138.04
Median
$177.83
Typical High
$416.87
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$66.07
Median
$123.03
Typical High
$125.89
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$26.30
Median
$48.98
Typical High
$51.29
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$104.71
Median
$194.98
Typical High
$194.98

Where New Hampshire sits

The same service costs 4.0 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 15th of 51

$263

AK $479TX $120

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.