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Unlisted X-Ray Imaging Study

Wisconsin 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?

$263

Typical facility fee. In Wisconsin, October 2026.

Insurers have agreed to pay about $263 for this service. Most negotiated rates run $219 to $363.

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.

How much rates vary

Facilitymedian $240 · 10th to 90th $200 to $331Professionalmedian $1,622 · 10th to 90th $209 to $1,622
$100$200$500$1Kfacility $240professional $1,622

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
$199.53
Median
$199.53
Typical High
$199.53
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$177.83
Median
$263.03
Typical High
$645.65
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$109.65
Median
$123.03
Typical High
$165.96
DeanCare
Setting
Facility
Modifier
None
Typical Low
$218.78
Median
$269.15
Typical High
$338.84
DeanCare
Setting
Facility
Modifier
80 · Assistant surgeon
Typical Low
$34.67
Median
$42.66
Typical High
$54.95
DeanCare
Setting
Facility
Modifier
81 · Minimal assistant surgeon
Typical Low
$34.67
Median
$42.66
Typical High
$54.95
DeanCare
Setting
Facility
Modifier
82 · Assistant surgeon, no resident
Typical Low
$34.67
Median
$42.66
Typical High
$54.95
DeanCare
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$30.20
Median
$38.02
Typical High
$47.86
DeanCare
Setting
Facility
Modifier
TC · Technical part
Typical Low
$218.78
Median
$269.15
Typical High
$338.84
Medica
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$223.87
Typical High
$223.87
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$489.78
Median
$1,621.81
Typical High
$1,621.81
Prevea360
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
United
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$229.09

Where Wisconsin 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.

Wisconsin· 12th of 51

$263

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.