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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 July 2026.

Facilitymedian $288 · 10th–90th $52$3720%20%10th90th$288Professionalmedian $209 · 10th–90th $32$6460%10%20%10th90th$209$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$263.03
Typical High
$645.65
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$257.04
Typical High
$338.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$70.79
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$489.78
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$52.48
Typical High
$89.13
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$104.71
Typical High
$229.09