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Initial Physical Therapy Evaluation

Wisconsin rates for HCPCS 97001

This covers an initial evaluation performed by a physical therapist to assess a patient's movement, strength, flexibility, and overall physical function. The therapist uses this assessment to identify problem areas and develop a personalized treatment plan. This evaluation typically takes place before ongoing physical therapy treatment sessions begin.

Rates data updated July 2026.

How much does Initial Physical Therapy Evaluation cost?

$85.11

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $75.86 from a physician practice, and about $141 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$75.86$66.07 to $129
FacilityA hospital or hospital-owned outpatient department$141$87.10 to $234

How much rates vary

Facilitymedian $141 · 10th to 90th $71 to $282Professionalmedian $76 · 10th to 90th $59 to $347
$100$200facility $141professional $76

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$213.80
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$74.13
Typical High
$75.86
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$89.13
Typical High
$141.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$114.82
Typical High
$281.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$89.13
Typical High
$141.25
Quartz
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$281.84
Typical High
$281.84
Quartz
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$346.74
Typical High
$346.74

Where Wisconsin sits

The same service costs 426.6 times more in Kentucky than in Michigan. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 21st of 37

$85.11

KY $28,184MI $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.