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Non-Invasive Liver Stiffness Test

Utah 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 $17 · 10th–90th $17$170%50%90th$17Professionalmedian $29 · 10th–90th $11$650%5%10th90th$29$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$40.74
Typical High
$158.49
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$9.77
Median
$16.98
Typical High
$53.70
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$19.05
Median
$23.99
Typical High
$43.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$46.77
Typical High
$70.79
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$12.02
Median
$19.05
Typical High
$27.54
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$21.88
Median
$27.54
Typical High
$42.66
Molina
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$33.11
Typical High
$60.26
Regence BlueShield
Setting
Facility
Modifier
26 · Professional part
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$35.48
Typical High
$74.13
Regence BlueShield
Setting
Professional
Modifier
26 · Professional part
Typical Low
$10.00
Median
$11.75
Typical High
$31.62
Regence BlueShield
Setting
Professional
Modifier
TC · Technical part
Typical Low
$19.95
Median
$23.44
Typical High
$43.65
Select Health
Setting
Facility
Modifier
26 · Professional part
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
Select Health
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$46.77
Typical High
$54.95
Select Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$10.47
Median
$15.85
Typical High
$18.20
Select Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$20.42
Median
$30.90
Typical High
$36.31
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$28.84
Typical High
$61.66
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$40.74
Typical High
$61.66
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$11.48
Median
$15.85
Typical High
$25.12
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$19.05
Median
$23.99
Typical High
$38.90