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Physical Therapy Evaluation, High Complexity

Connecticut 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?

$74.13

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $251 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 6 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$74.13$58.88 to $87.10
FacilityA hospital or hospital-owned outpatient department$251$138 to $288

How much rates vary

Facilitymedian $251 · 10th to 90th $74 to $347Professionalmedian $74 · 10th to 90th $49 to $115
$50.0$100.0$200.0$500.0facility $251professional $74

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
$74.13
Median
$269.15
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$70.79
Typical High
$100.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$331.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$81.28
Typical High
$120.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$177.83
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$109.65
Typical High
$114.82
Health New England
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$263.03
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$128.82

Where Connecticut 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.

Connecticut $74.13 · 42nd 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.