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Unlisted X-Ray Imaging Study

Virginia 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?

$204

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $19.95 from a physician practice, and about $209 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$19.95$19.95 to $100
FacilityA hospital or hospital-owned outpatient department$209$166 to $407

How much rates vary

Facilitymedian $209 · 10th to 90th $120 to $832Professionalmedian $20 · 10th to 90th $20 to $4,571
$20$100$500$2Kfacility $209professional $20

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
Professional
Modifier
TC · Technical part
Typical Low
$41.69
Median
$46.77
Typical High
$51.29
CareFirst
Setting
Professional
Modifier
None (both parts)
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$208.93
Typical High
$776.25
Medcost
Setting
Professional
Modifier
TC · Technical part
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Sentara
Setting
Facility
Modifier
None
Typical Low
$4,570.88
Median
$4,570.88
Typical High
$7,413.10
Sentara
Setting
Professional
Modifier
None (both parts)
Typical Low
$100.00
Median
$4,570.88
Typical High
$7,413.10
United
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$181.97
Typical High
$407.38
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$186.21
Median
$186.21
Typical High
$186.21

Where Virginia 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.

Virginia· 18th of 51

$204

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.