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CT Scan Procedure With No Standard Listing

Pennsylvania rates for HCPCS 76497

Covers a CT scan, or a procedure guided by CT, that does not match any of the standard named studies. CT uses X-rays taken from many angles around the body and assembles them by computer into detailed cross-sectional pictures. Because it stands in for something unusual, a written description of exactly what was performed accompanies it.

Rates data updated July 2026.

How much does CT Scan Procedure With No Standard Listing cost?

$120

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $347 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 8 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$107$95.50 to $170
FacilityA hospital or hospital-owned outpatient department$347$162 to $575

How much rates vary

Facilitymedian $347 · 10th to 90th $91 to $1,380Professionalmedian $107 · 10th to 90th $87 to $275
$100$1K$10Kfacility $347professional $107

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$346.74
Typical High
$1,380.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$107.15
Typical High
$275.42
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$64,565.42
Median
$64,565.42
Typical High
$64,565.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$204.17
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$151.36
Typical High
$331.13
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$57,543.99
Median
$57,543.99
Typical High
$57,543.99
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$302.00
Typical High
$512.86
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$371.54
Typical High
$1,348.96
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$107.15
Typical High
$302.00
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$77.62
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$208.93
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$602.56
Typical High
$691.83

Where Pennsylvania sits

The same service costs 3.5 times more in Louisiana than in Vermont. 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.

Pennsylvania· 30th of 51

$120

LA $302VT $87.10

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.