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Utah rates for HCPCS 91200

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

Facilitymedian $17 · 10th–90th $17$170%50%$17Professionalmedian $28 · 10th–90th $12$660%5%10th90th$28$2.0$5.0$10.0$20.0$50.0$100.0$200.0

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
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $41.69 / $165.96
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$9.77 / $16.98 / $50.12
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$18.20 / $22.91 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $46.77 / $70.79
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$12.30 / $19.05 / $27.54
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$22.39 / $27.54 / $42.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $32.36 / $45.71
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $37.15 / $85.11
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$10.00 / $12.59 / $35.48
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.95 / $24.55 / $48.98
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $46.77 / $74.13
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$10.72 / $16.60 / $26.30
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$20.89 / $27.54 / $31.62
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $28.84 / $61.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $40.74 / $63.10
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$12.02 / $16.22 / $25.70
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$19.05 / $24.55 / $38.90