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Physical Therapy Evaluation, High Complexity

Colorado 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 July 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$81.28

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $110 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$77.62$60.26 to $95.50
FacilityA hospital or hospital-owned outpatient department$110$87.10 to $174

How much rates vary

Facilitymedian $110 · 10th to 90th $78 to $380Professionalmedian $78 · 10th to 90th $49 to $174
$2.0$10.0$50.0$200.0facility $110professional $78

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$158.49
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$77.62
Typical High
$302.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$97.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$67.61
Typical High
$131.83
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$93.33
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$144.54
Typical High
$257.04
Select Health
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$204.17
Typical High
$213.80
Select Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$104.71
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$100.00
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$114.82

Where Colorado sits

The same service costs 2.6 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Colorado $81.28 · 25th of 51
AK $170DE $66.07

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.