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Unlisted X-Ray Imaging Study

Ohio 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.

Facilitymedian $158 · 10th–90th $102$4370%20%10th90th$158Professionalmedian $0 · 10th–90th $0$500%50%90th$0$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$467.74
Typical High
$645.65
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.04
CareSource
Setting
Facility
Modifier
Global
Typical Low
$72,443.60
Median
$72,443.60
Typical High
$72,443.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$302.00
Typical High
$478.63
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$316.23
Typical High
$478.63
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$60.26
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$69.18
Typical High
$208.93