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Physical Therapy Evaluation, Moderate Complexity

Wisconsin 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 $182 · 10th–90th $79$3980%10%10th90th$182Professionalmedian $107 · 10th–90th $65$3090%10%10th90th$107$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$91.20
Typical High
$309.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$81.28
Typical High
$263.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$275.42
Typical High
$363.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$147.91
Typical High
$302.00
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$95.50
Typical High
$204.17
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$190.55
Typical High
$288.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$218.78
Typical High
$346.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$125.89
Typical High
$338.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$64.57
Network Health
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Network Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$114.82
Typical High
$239.88
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$95.50
Typical High
$204.17
Quartz
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$213.80
Typical High
$316.23
Quartz
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$239.88
Typical High
$630.96
Quartz
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$426.58
Typical High
$630.96
Security Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Security Health
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Security Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$213.80
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$269.15