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Unlisted X-Ray Imaging Study

Montana 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?

$79.43

Typical facility fee. In Montana, October 2026.

Insurers have agreed to pay about $79.43 for this service. Most negotiated rates run $79.43 to $79.43.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $148 · 10th to 90th $148 to $316Professionalmedian $79 · 10th to 90th $79 to $79
$100$200facility $148professional $79

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
Facility
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Providence
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Providence
Setting
Professional
Modifier
None (both parts)
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
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
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$41.69
Median
$41.69
Typical High
$63.10

Where Montana 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.

Montana· 43rd of 51

$79.43

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.