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Unlisted X-Ray Imaging Study

Pennsylvania 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 $107 · 10th–90th $48$2570%10%20%10th90th$107Professionalmedian $724 · 10th–90th $724$64,5650%50%90th$724$50.0$200.0$1.0K$5.0K$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
$85.11
Median
$165.96
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$64,565.42
Median
$64,565.42
Typical High
$64,565.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$190.55
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$165.96
Typical High
$199.53
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$60.26
Typical High
$93.33
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$208.93
Typical High
$288.40