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Physical Therapy Evaluation, High Complexity

Arizona rates for HCPCS 97163

A physical therapist assesses a person's movement, strength, and physical function to understand how an injury or condition is limiting them, then develops a plan of care. This version applies to more complicated cases, involving a more extensive health history and a higher number of factors affecting movement and function than a simpler evaluation.

Rates data updated October 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$81.28

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $81.28 from a physician practice, and about $257 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$81.28$75.86 to $87.10
FacilityA hospital or hospital-owned outpatient department$257$105 to $389

How much rates vary

Facilitymedian $257 · 10th to 90th $78 to $457Professionalmedian $81 · 10th to 90th $62 to $129
$100$200$500facility $257professional $81

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$165.96
Typical High
$380.19
Aetna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$81.28
Typical High
$87.10
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$309.03
Typical High
$457.09
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$75.86
Typical High
$85.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$85.11
Typical High
$104.71
Medica
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$100.00
Typical High
$223.87
Medica
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$87.10
Typical High
$630.96
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$87.10
Typical High
$97.72
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Ambetter
Setting
Professional
Modifier
GP · Physical therapy plan
Typical Low
$69.18
Median
$69.18
Typical High
$77.62

Where Arizona sits

The same service costs 3.3 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 33rd of 51

$81.28

AK $200FL $60.26

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.