go back

Alabama 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.

Facilitymedian $95 · 10th–90th $55–$1510%50%10th90th$95Professionalmedian $81 · 10th–90th $54–$1580%10%10th90th$81$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $95.50 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $83.18 / $158.49
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $58.88 / $79.43
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $95.50 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $64.57 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $77.62 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $74.13 / $104.71