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Physical Therapy Evaluation, Lower Complexity

Colorado 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?

$83.18

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $100 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 7 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$79.43$61.66 to $95.50
FacilityA hospital or hospital-owned outpatient department$100$87.10 to $166

How much rates vary

Facilitymedian $100 · 10th to 90th $78 to $380Professionalmedian $79 · 10th to 90th $49 to $158
$50$100$200$500facility $100professional $79

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
$87.10
Median
$112.20
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$79.43
Typical High
$208.93
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$97.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$67.61
Typical High
$131.83
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$93.33
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$154.88
Typical High
$204.17
Select Health
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$204.17
Typical High
$213.80
Select Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$104.71
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$100.00
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$117.49

Where Colorado 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.

Colorado· 26th of 51

$83.18

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.