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Physical Therapy Evaluation, Moderate Complexity

Illinois rates for HCPCS 97162

This is an initial evaluation by a physical therapist to assess a person's condition, movement, and physical function in order to build a treatment plan. It reflects a moderate level of clinical complexity, more involved than the most straightforward evaluations but less involved than the most complex cases.

Rates data updated July 2026.

Facilitymedian $162 · 10th–90th $81$3160%10%10th90th$162Professionalmedian $79 · 10th–90th $58$1290%10%20%10th90th$79$20.0$50.0$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$158.49
Typical High
$309.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$75.86
Typical High
$117.49
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$218.78
Typical High
$707.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$100.00
Typical High
$102.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$112.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$81.28
Typical High
$154.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$141.25
Typical High
$229.09
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$131.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$158.49