Tynbil: Know the *real* price for healthcare services

Washington, DC 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.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.00 / $199.15 / $407.58	Facility	$143.00	$199.15	$407.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.45 / $78.33 / $78.33	Professional	$58.45	$78.33	$78.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $82.87 / $82.87 / $288.00	Professional	$82.87	$82.87	$288.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $81.09 / $101.29	Professional	$61.97	$81.09	$101.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.06 / $110.07 / $110.07	Professional	$103.06	$110.07	$110.07
United Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $96.23 / $249.59	Professional	$64.45	$96.23	$249.59