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North Dakota rates for HCPCS 97161

Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $257 · 10th–90th $98–$3390%20%10th90th$257Professionalmedian $115 · 10th–90th $59–$2340%10%10th90th$115$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $263.03 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $95.50 / $213.80
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $218.78 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $107.15 / $112.20
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $131.83 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $141.25 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $91.20 / $239.88