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Oklahoma 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 $87 · 10th–90th $65–$1550%20%10th90th$87Professionalmedian $85 · 10th–90th $58–$1290%20%10th90th$85$50.0$200.0$1.0K$5.0K$20.0K

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
$69.18 / $89.13 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $72.44 / $125.89
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$89.13 / $144.54 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $93.33 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $95.50 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $64.57 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $87.10 / $123.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $83.18 / $223.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $79.43 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $77.62 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $74.13 / $102.33