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Physical Therapy Evaluation, Lower Complexity

Arizona 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?

$79.43

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $166 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 5 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$77.62$63.10 to $107
FacilityA hospital or hospital-owned outpatient department$166$83.18 to $347

How much rates vary

Facilitymedian $166 · 10th to 90th $69 to $398Professionalmedian $78 · 10th to 90th $56 to $295
$50$100$200$500facility $166professional $78

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
$81.28
Median
$213.80
Typical High
$398.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$77.62
Typical High
$295.12
BCBS
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$204.17
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$79.43
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$57.54
Typical High
$81.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$93.33
Typical High
$158.49
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$87.10
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$144.54
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$87.10
Typical High
$131.83

Where Arizona 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.

Arizona· 38th of 51

$79.43

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.