go back

Physical Therapy Evaluation, Moderate Complexity

North Carolina 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 $93 · 10th–90th $76$1740%20%10th90th$93Professionalmedian $79 · 10th–90th $59$1480%20%10th90th$79$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$83.18
Median
$100.00
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$81.28
Typical High
$165.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
BCBS
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$190.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$75.86
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$77.62
Typical High
$141.25
Medcost
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$85.11
Typical High
$128.82
Medcost
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$89.13
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$81.28
Typical High
$128.82
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$831.76
Typical High
$831.76