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CT Scan Procedure With No Standard Listing

Wisconsin 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?

$141

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $141 for this service. The price depends on where it is billed: about $132 from a physician practice, and about $214 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 9 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$132$95.50 to $380
FacilityA hospital or hospital-owned outpatient department$214$135 to $575

How much rates vary

Facilitymedian $214 · 10th to 90th $105 to $955Professionalmedian $132 · 10th to 90th $83 to $676
$50$100$200$500$1K$2Kfacility $214professional $132

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
$213.80
Median
$575.44
Typical High
$954.99
Aetna
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$114.82
Typical High
$213.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$524.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$537.03
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$407.38
Typical High
$457.09
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$213.80
Typical High
$436.52
Medica
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$190.55
Typical High
$1,445.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$660.69
Typical High
$660.69
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$123.03
Typical High
$213.80
Quartz
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$257.04
Typical High
$363.08
Quartz
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$2,630.27
Typical High
$2,630.27
Quartz
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$524.81
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$104.71
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$190.55
Typical High
$707.95

Where Wisconsin 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.

Wisconsin· 12th of 51

$141

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.