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Unlisted X-Ray Imaging Study

Massachusetts rates for HCPCS 76499

Covers a diagnostic imaging study using X-rays that has no standard named entry of its own. It is used when the examination performed does not match any of the established named X-ray studies, so the doctor supplies a written description of exactly what was done and why.

Rates data updated October 2026.

How much does Unlisted X-Ray Imaging Study cost?

$275

Typical negotiated rate. In Massachusetts, October 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $2,512 from a physician practice, and about $219 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,512$646 to $3,020
FacilityA hospital or hospital-owned outpatient department$219$115 to $3,467

How much rates vary

Facilitymedian $219 · 10th to 90th $89 to $4,898Professionalmedian $2,512 · 10th to 90th $178 to $3,020
$50$100$200$500$1K$2K$5Kfacility $219professional $2,512

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
$177.83
Median
$288.40
Typical High
$645.65
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$42.66
Median
$45.71
Typical High
$63.10
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$138.04
Typical High
$162.18
BCBS Massachusetts
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$104.71
Typical High
$141.25
Cigna
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$173.78
Typical High
$275.42
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$3,630.78
Typical High
$8,511.38
Health New England
Setting
Facility
Modifier
None
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$138.04
Typical High
$162.18
United
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$229.09
Typical High
$338.84
Well Sense
Setting
Facility
Modifier
None
Typical Low
$2,511.89
Median
$3,467.37
Typical High
$5,754.40
Well Sense
Setting
Professional
Modifier
None (both parts)
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$3,019.95

Where Massachusetts sits

The same service costs 20.9 times more in New Hampshire than in Delaware. 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.

Massachusetts· 8th of 51

$275

NH $646DE $30.90

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.