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Non-Invasive Liver Stiffness Test

South Dakota rates for HCPCS 91200

This is a quick, painless test that uses gentle vibration and sound wave measurements taken through a handheld device pressed against the skin over the liver to estimate how stiff the liver tissue is. Increased stiffness can be a sign of scarring in the liver, so this test is used to help assess liver health without a surgical biopsy.

Rates data updated July 2026.

Facilitymedian $14 · 10th–90th $14$140%50%100%$14Professionalmedian $35 · 10th–90th $10$850%5%10%10th90th$35$10.0$20.0$50.0$100.0

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
26 · Professional part
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$60.26
Typical High
$131.83
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$9.77
Median
$10.72
Typical High
$34.67
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$20.89
Median
$56.23
Typical High
$64.57
Avera
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$64.57
Typical High
$81.28
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$21.38
Median
$21.38
Typical High
$26.92
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$42.66
Median
$42.66
Typical High
$53.70
Medica
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$66.07
Typical High
$109.65
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$13.80
Median
$23.44
Typical High
$38.90
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$23.99
Median
$39.81
Typical High
$70.79
Midlands
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$74.13
Typical High
$74.13
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$25.12
Median
$25.70
Typical High
$28.18
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$38.90
Median
$47.86
Typical High
$47.86
Midlands
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$27.54
Median
$27.54
Typical High
$27.54
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$58.88
Typical High
$63.10
Sanford Health Plan
Setting
Professional
Modifier
26 · Professional part
Typical Low
$13.49
Median
$19.95
Typical High
$23.99
Sanford Health Plan
Setting
Professional
Modifier
TC · Technical part
Typical Low
$25.70
Median
$35.48
Typical High
$40.74
United
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$66.07
Typical High
$85.11
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$13.49
Median
$22.91
Typical High
$29.51
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$23.99
Median
$41.69
Typical High
$56.23
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$72.44
Typical High
$75.86
Wellmark
Setting
Professional
Modifier
26 · Professional part
Typical Low
$20.42
Median
$23.99
Typical High
$24.55
Wellmark
Setting
Professional
Modifier
TC · Technical part
Typical Low
$41.69
Median
$48.98
Typical High
$51.29