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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 October 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$79.43

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

Insurers have agreed to pay about $79.43 for this service. Most negotiated rates run $77.62 to $87.10.

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 $263Professionalmedian $79 · 10th to 90th $72 to $110
$100$200facility $191professional $79

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$77.62
Median
$190.55
Typical High
$263.03
Aetna
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$77.62
Typical High
$85.11
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$37.15
Median
$38.90
Typical High
$38.90
CareFirst
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$85.11
Typical High
$87.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$77.62
Typical High
$138.04
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$109.65
Typical High
$169.82
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$100.00
Typical High
$257.04

Where Washington, DC 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.

Washington, DC· 34th of 51

$79.43

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.