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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 October 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$74.13

Typical negotiated rate. In Connecticut, October 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 $224 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$74.13$67.61 to $85.11
FacilityA hospital or hospital-owned outpatient department$224$174 to $288

How much rates vary

Facilitymedian $224 · 10th to 90th $129 to $380Professionalmedian $74 · 10th to 90th $63 to $100
$50$100$200facility $224professional $74

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
$102.33
Median
$169.82
Typical High
$389.05
Aetna
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$74.13
Typical High
$77.62
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$30.20
Median
$37.15
Typical High
$37.15
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$223.87
Typical High
$346.74
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$74.13
Typical High
$97.72
Cigna
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$75.86
Typical High
$125.89
ConnectiCare
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$109.65
Typical High
$114.82
Health New England
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$288.40
Typical High
$407.38
Health New England
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
United
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$85.11
Typical High
$123.03

Where Connecticut 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.

Connecticut· 44th of 51

$74.13

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.