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Physical Therapy Evaluation, Lower Complexity

New Hampshire 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?

$107

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $117 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$107$77.62 to $158
FacilityA hospital or hospital-owned outpatient department$117$63.10 to $158

How much rates vary

Facilitymedian $117 · 10th to 90th $63 to $372Professionalmedian $107 · 10th to 90th $63 to $229
$100$200$500$1K$2K$5Kfacility $117professional $107

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
$63.10
Median
$117.49
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$66.07
Typical High
$128.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$97.72
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$204.17
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$158.49
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$93.33
Typical High
$208.93
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$89.13
Typical High
$123.03
Well Sense
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70

Where New Hampshire 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.

New Hampshire· 11th of 51

$107

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.