go back

New Hampshire rates for HCPCS 91200

Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report

Facilitymedian $15 · 10th–90th $15$150%50%$15Professionalmedian $28 · 10th–90th $11$690%5%10th90th$28$10.0$20.0$50.0$100.0$200.0$500.0

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
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $97.72
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$8.91 / $14.13 / $31.62
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$16.60 / $21.88 / $41.69
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $114.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $52.48 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$10.96 / $17.78 / $25.12
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.91 / $33.88 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $47.86 / $89.13
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$11.48 / $18.20 / $33.88
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $32.36 / $56.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $93.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$12.59 / $19.05 / $29.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$26.30 / $38.02 / $63.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $120.23
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$12.88 / $22.39 / $39.81
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$25.12 / $40.74 / $77.62
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$7.76 / $7.76 / $8.51