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Unlisted X-Ray Imaging Study

Maine 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 rates vary

Facilitymedian $575 · 10th to 90th $575 to $575
facility $575

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
TC · Technical part
Typical Low
$51.29
Median
$52.48
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$77.62
Median
$87.10
Typical High
$213.80
Martin's Point
Setting
Professional
Modifier
TC · Technical part
Typical Low
$51.29
Median
$52.48
Typical High
$107.15
1 more rate 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
Cigna
Setting
Facility
Modifier
None
Typical Low
$575.44
Median
$575.44
Typical High
$575.44