Tynbil: Know the *real* price for healthcare services

Nationwide rates for HCPCS 97161

Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.69 / $150.18 / $271.85	Facility		$80.69	$150.18	$271.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.12 / $73.63 / $166.66	Professional		$57.12	$73.63	$166.66
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $89.46 / $89.46 / $89.46	Professional	CQ	$89.46	$89.46	$89.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.83 / $92.65 / $182.00	Facility		$74.83	$92.65	$182.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $78.94 / $133.19	Professional		$63.84	$78.94	$133.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $72.00 / $113.06	Facility		$65.00	$72.00	$113.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $85.66 / $132.49	Professional		$61.97	$85.66	$132.49
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Facility		$300.00	$300.00	$300.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.70 / $86.62 / $125.40	Professional		$68.70	$86.62	$125.40

Nationwide rates for HCPCS 97161

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