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Physical Therapy Evaluation, Lower Complexity

Tennessee 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?

$75.86

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $75.86 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $102 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$72.44$60.26 to $95.50
FacilityA hospital or hospital-owned outpatient department$102$75.86 to $204

How much rates vary

Facilitymedian $102 · 10th to 90th $62 to $331Professionalmedian $72 · 10th to 90th $55 to $155
$50$100$200$500facility $102professional $72

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
$61.66
Median
$100.00
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$67.61
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$81.28
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$67.61
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$83.18
Typical High
$151.36
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$630.96
Typical High
$630.96
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$831.76
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$100.00

Where Tennessee 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.

Tennessee· 46th of 51

$75.86

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.