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South Carolina 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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $93.33 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $83.18 / $169.82
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$144.54 / $144.54 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $151.36 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $74.13 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $70.79 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $70.79 / $112.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $83.18 / $141.25
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $72.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $77.62 / $97.72