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Hawaii rates for HCPCS 97162

Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $138 · 10th–90th $135–$6030%50%10th90th$138Professionalmedian $91 · 10th–90th $58–$1580%10%10th90th$91$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $138.04 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $79.43 / $134.90
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $131.83
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $120.23 / $147.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $114.82 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $100.00 / $131.83
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $257.04