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Physical Therapy Evaluation, Lower Complexity

Alabama rates for HCPCS 97161

This is an initial evaluation by a physical therapist for a condition involving a limited number of body areas and a fairly stable or predictable clinical picture. The therapist reviews the patient's history, examines movement and function, and creates a plan of care. It's typically used for straightforward cases rather than complex or evolving conditions.

Rates data updated July 2026.

How much does Physical Therapy Evaluation, Lower Complexity cost?

$72.44

Typical negotiated rate. In Alabama, July 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $91.20 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 4 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$70.79$60.26 to $87.10
FacilityA hospital or hospital-owned outpatient department$91.20$61.66 to $97.72

How much rates vary

Facilitymedian $91 · 10th to 90th $54 to $102Professionalmedian $71 · 10th to 90th $49 to $107
$50$100$200facility $91professional $71

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$97.72
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$70.79
Typical High
$107.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$58.88
Typical High
$79.43
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$95.50
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$64.57
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$72.44
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$77.62
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$74.13
Typical High
$107.15

Where Alabama sits

The same service costs 3.2 times more in West Virginia than in Delaware. 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.

Alabama· 49th of 51

$72.44

WV $209DE $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.