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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.

Facilitymedian $269 · 10th–90th $83$4470%20%10th90th$269Professionalmedian $724 · 10th–90th $282$5,0120%50%10th90th$724$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$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