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Physical Therapy Evaluation, Lower Complexity

Minnesota 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?

$148

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $229 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 6 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$138$87.10 to $269
FacilityA hospital or hospital-owned outpatient department$229$155 to $437

How much rates vary

Facilitymedian $229 · 10th to 90th $115 to $550Professionalmedian $138 · 10th to 90th $71 to $295
$50$100$200$500$1Kfacility $229professional $138

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
$91.20
Median
$91.20
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$79.43
Typical High
$295.12
BCBS
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$457.09
Typical High
$575.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$223.87
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$363.08
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$169.82
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$426.58
Typical High
$457.09
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$138.04
Medica
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$288.40
Medica
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$263.03
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$107.15
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$288.40

Where Minnesota 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.

Minnesota· 3rd of 51

$148

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.