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Physical Therapy Evaluation, Lower Complexity

Washington, DC 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?

$77.62

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $77.62 for this service. Most negotiated rates run $74.13 to $132.

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.

How much rates vary

Facilitymedian $240 · 10th to 90th $78 to $912Professionalmedian $78 · 10th to 90th $50 to $110
$100$200$500$1K$2K$5Kfacility $240professional $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
$77.62
Median
$239.88
Typical High
$912.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$75.86
Typical High
$77.62
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$165.96
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$77.62
Typical High
$234.42
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$229.09

Where Washington, DC 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.

Washington, DC· 43rd of 51

$77.62

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.