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Detailed Layered X-Ray Imaging, Both Sides

Wisconsin rates for HCPCS 76102

This covers an older type of X-ray technique that creates a focused image of a thin slice of tissue, performed on both sides of the body. It was historically used for detailed imaging of certain bone structures, such as around the ear, before more advanced imaging like CT scans became widely available. It is a specialized and now uncommon type of imaging study.

Rates data updated July 2026.

How much does Detailed Layered X-Ray Imaging, Both Sides cost?

$661

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $741 from a physician practice, and about $562 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$741$661 to $1,175
FacilityA hospital or hospital-owned outpatient department$562$479 to $759

How much rates vary

Facilitymedian $562 · 10th to 90th $302 to $813Professionalmedian $741 · 10th to 90th $269 to $1,175
$50$100$200$500$1Kfacility $562professional $741

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$562.34
Typical High
$891.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$660.69
Typical High
$758.58
Medica
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$70.79
Quartz
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$758.58
Typical High
$758.58
Quartz
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,174.90
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$69.18
Typical High
$138.04

Where Wisconsin sits

The same service costs 38.9 times more in Missouri than in South Carolina. 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.

Wisconsin· 10th of 41

$661

MO $1,175SC $30.20

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.