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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 October 2026.

How much does Unlisted X-Ray Imaging Study cost?

$102

Typical negotiated rate. In Ohio, October 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $295 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$50.12$50.12 to $60.26
FacilityA hospital or hospital-owned outpatient department$295$257 to $355

How much rates vary

Facilitymedian $295 · 10th to 90th $174 to $479Professionalmedian $50 · 10th to 90th $40 to $60
$50$100$200$500facility $295professional $50

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$177.83
Median
$467.74
Typical High
$645.65
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Cigna
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$302.00
Typical High
$478.63
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$302.00
Typical High
$478.63
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$39.81
Median
$50.12
Typical High
$60.26
SummaCare
Setting
Professional
Modifier
None (both parts)
Typical Low
$50.12
Median
$50.12
Typical High
$70.79
United
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$208.93
Typical High
$295.12

Where Ohio 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.

Ohio· 38th of 51

$102

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.