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Physical Therapy Evaluation, Lower Complexity

Utah 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?

$93.33

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $87.10 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$93.33$75.86 to $120
FacilityA hospital or hospital-owned outpatient department$87.10$87.10 to $126

How much rates vary

Facilitymedian $87 · 10th to 90th $87 to $141Professionalmedian $93 · 10th to 90th $58 to $316
$50$100$200$500facility $87professional $93

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
$87.10
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$93.33
Typical High
$316.23
Aetna
Setting
Professional
Modifier
CQ · PT assistant
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$95.50
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$229.09
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$141.25
Typical High
$181.97
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$104.71
Typical High
$123.03
Select Health
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$114.82
Select Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$102.33
Typical High
$114.82
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$131.83
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$109.65

Where Utah 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.

Utah· 19th of 51

$93.33

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.