go back

Nebraska 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 $174 · 10th–90th $105–$2400%10%10th90th$174Professionalmedian $115 · 10th–90th $66–$3020%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
$123.03 / $177.83 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $316.23
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $281.84 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $151.36 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $213.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $169.82 / $229.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $158.49 / $223.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $213.80
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $109.65 / $229.09
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $87.10 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $83.18 / $213.80