91200

Measurement of liver stiffness

Medicare pricing data for 3,966 providers across 52 states

🤖AI Overview

This procedure has a 5.7x markup — hospitals charge $122.93 but Medicare allows only $21.39. Uninsured patients may face bills 5.7 times higher than what insurance negotiates. Prices vary significantly by location — from $9 in North Dakota to $33 in District of Columbia. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Measurement of liver stiffness (HCPCS code 91200) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $21.39, but hospitals typically charge $122.93 — a 5.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.28

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $21.39, your out-of-pocket cost would be approximately $4.28. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$21.39
Average Hospital Charge
$122.93
Markup Ratio
5.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$122.93
Medicare Allowed$21.39
Medicare Payment$15.54

Hospitals charge 5.7x more than what Medicare allows for this procedure. Medicare actually pays $15.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$33$971684+52.8%
Puerto Rico$31$1421065+42.7%
Rhode Island$29$1389173+37.1%
Wyoming$28$2955102+29.2%
Nevada$28$19225280+28.6%
California$26$1343846,596+21.7%
New York$26$1582894,575+19.8%
Maryland$25$9492697+18.2%
New Jersey$25$1101331,408+16.5%
Texas$25$1323204,072+15.8%
Florida$24$1962114,238+14.4%
Mississippi$24$125792,483+12.2%
Connecticut$24$19946539+12.1%
Tennessee$22$871092,252+3.6%
Washington$22$7755969+3.2%
Nebraska$22$7637272+2.5%
Georgia$22$12986762+1.6%
Arkansas$22$10434499+1.4%
Colorado$22$8768599+1.2%
Louisiana$22$15780609+0.7%
Oregon$21$10233310+0.2%
Alabama$21$4747312+0.2%
West Virginia$21$10025380-1.5%
New Hampshire$20$6932501-5.1%
Hawaii$20$7530213-6.2%
Kansas$20$13228341-6.3%
North Carolina$20$1461601,421-7.6%
Pennsylvania$20$882251,990-7.6%
Illinois$18$1251632,243-14.8%
Indiana$18$75681,387-16.6%
Massachusetts$17$901282,698-18.9%
Minnesota$17$14672752-19.7%
Missouri$17$153671,275-21.5%
Ohio$17$971702,289-21.9%
Iowa$17$7344493-22.4%
Arizona$17$107771,367-22.5%
Utah$16$6547687-23.6%
Michigan$16$8778894-24.2%
Wisconsin$16$21790607-24.9%
South Carolina$16$5633252-25.2%
South Dakota$16$2916199-26.1%
Maine$15$15715185-28.1%
New Mexico$15$13035447-28.9%
Virginia$14$104741,470-35.3%
Alaska$13$1365120-38.9%
Oklahoma$13$5018233-41.4%
Kentucky$11$4145562-46.4%
Montana$10$32375-51.1%
Idaho$10$28862-52.9%
Delaware$9$54114-57.1%
Vermont$9$25468-57.8%
North Dakota$9$4019208-58.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber