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Physical Therapy Evaluation, High Complexity

Washington, DC 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?

$77.62

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $77.62 for this service. Most negotiated rates run $74.13 to $107.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $191 · 10th to 90th $78 to $447Professionalmedian $78 · 10th to 90th $50 to $110
$50.0$100.0$200.0$500.0$1.0Kfacility $191professional $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
$77.62
Median
$190.55
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$75.86
Typical High
$77.62
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$165.96
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$77.62
Typical High
$234.42
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$229.09

Where Washington, DC 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.

Washington, DC $77.62 · 31st 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.