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Unlisted X-Ray Imaging Study

Utah 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?

$302

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $724 from a physician practice, and about $269 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$724$282 to $724
FacilityA hospital or hospital-owned outpatient department$269$126 to $269

How much rates vary

Facilitymedian $269 · 10th to 90th $83 to $447Professionalmedian $724 · 10th to 90th $282 to $5,012
$50$100$200$500$1K$2K$5Kfacility $269professional $724

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$269.15
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$724.44
Typical High
$724.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$125.89
Typical High
$724.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$60.26
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$281.84
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90

Where Utah 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.

Utah· 14th of 50

$302

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.