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Unlisted X-Ray Imaging Study

South Dakota 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 $316 · 10th to 90th $316 to $316Professionalmedian $32 · 10th to 90th $32 to $32
$50$100$200facility $316professional $32

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
None
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$32.36
Median
$32.36
Typical High
$32.36