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Physical Therapy Evaluation, Lower Complexity

Nebraska 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?

$141

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $141 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $182 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 7 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$112$95.50 to $229
FacilityA hospital or hospital-owned outpatient department$182$145 to $209

How much rates vary

Facilitymedian $182 · 10th to 90th $95 to $245Professionalmedian $112 · 10th to 90th $74 to $331
$100$200$500facility $182professional $112

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
$131.83
Median
$190.55
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$104.71
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$281.84
Typical High
$562.34
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$151.36
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$141.25
Typical High
$229.09
Medica
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$169.82
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$158.49
Typical High
$223.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$213.80
Midlands
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Midlands
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$109.65
Typical High
$229.09
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$87.10
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$85.11
Typical High
$223.87

Where Nebraska 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.

Nebraska· 4th of 51

$141

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.