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Alaska rates for HCPCS 97163

Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $123 · 10th–90th $76–$2750%10%10th90th$123Professionalmedian $89 · 10th–90th $58–$2820%10%20%10th90th$89$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $245.47 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $83.18 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $107.15 / $281.84
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $109.65 / $269.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $251.19 / $436.52
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $3,467.37
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $346.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $97.72 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $102.33 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $234.42