GPT and liver disorder: This includes the cost of a full liver screen, liver ultrasound and onward consultation and investigation in secondary care (eg, national tariff for ultrasound scan £75.50, new patient consultant led hepatology outpatient appointment is £208.56.30 Furthermore, there is growing evidence that in advanced liver disease many individuals have a normal ALT,10 31 so the growth in use of this marker as a trigger for further assessment may still not identify liver disease.