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Physical Therapy Evaluation, High Complexity

Delaware 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?

$67.61

Typical physician fee. In Delaware, October 2026.

Insurers have agreed to pay about $67.61 for this service. Most negotiated rates run $63.10 to $83.18.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $102 · 10th to 90th $63 to $166Professionalmedian $68 · 10th to 90th $60 to $95
$50$100$200facility $102professional $68

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
$63.10
Median
$63.10
Typical High
$165.96
Aetna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$77.62
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$30.20
Median
$31.62
Typical High
$37.15
Cigna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$58.88
Median
$83.18
Typical High
$112.20
Highmark BCBS
Setting
Facility
Modifier
GP · Physical therapy plan
Typical Low
$95.50
Median
$263.03
Typical High
$645.65
Highmark BCBS
Setting
Professional
Modifier
GP · Physical therapy plan
Typical Low
$83.18
Median
$97.72
Typical High
$97.72
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$70.79
Typical High
$125.89

Where Delaware 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.

Delaware· 48th of 51

$67.61

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.