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Physical Therapy Evaluation, Lower Complexity

Idaho 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?

$91.20

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $91.20 for this service. The price depends on where it is billed: about $91.20 from a physician practice, and about $115 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 8 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$91.20$77.62 to $123
FacilityA hospital or hospital-owned outpatient department$115$97.72 to $158

How much rates vary

Facilitymedian $115 · 10th to 90th $89 to $234Professionalmedian $91 · 10th to 90th $63 to $195
$100$200facility $115professional $91

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
$95.50
Median
$114.82
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$87.10
Typical High
$199.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$141.25
Typical High
$208.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$190.55
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$75.86
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$95.50
Typical High
$141.25
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$158.49
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$194.98
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$223.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$107.15
Typical High
$147.91
Select Health
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$114.82
Typical High
$229.09
Select Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$87.10
Typical High
$91.20

Where Idaho 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.

Idaho· 20th of 51

$91.20

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.