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Unlisted X-Ray Imaging Study

New Hampshire 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 $646 · 10th to 90th $331 to $4,365
$500$1K$2K$5Kfacility $646

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
TC · Technical part
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$79.43
Median
$79.43
Typical High
$263.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$501.19
Typical High
$645.65
Well Sense
Setting
Facility
Modifier
None
Typical Low
$3,630.78
Median
$3,630.78
Typical High
$5,754.40