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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 July 2026.

How much does Unlisted X-Ray Imaging Study cost?

$692

Typical facility fee. In New Hampshire, July 2026.

Insurers have agreed to pay about $692 for this service. Most negotiated rates run $427 to $759.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $724 · 10th to 90th $363 to $2,754Professionalmedian $148 · 10th to 90th $148 to $263
$200$500$1K$2K$5Kfacility $724professional $148

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. 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
Global
Typical Low
$363.08
Median
$691.83
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$524.81
Typical High
$724.44
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$3,981.07
Typical High
$5,754.40

Where New Hampshire sits

The same service costs 23.4 times more in Iowa 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.

New Hampshire· 7th of 50

$692

IA $724DE $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.