Tynbil: Know the *real* price for healthcare services

Delaware 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 $63.17 / $162.34 / $162.34	Facility	$63.17	$162.34	$162.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.11 / $65.86 / $78.33	Professional	$49.11	$65.86	$78.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $65.00	Facility	$65.00	$65.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $81.09 / $100.55	Professional	$61.97	$81.09	$100.55
United Facility/Professional Professional Modifier Low / Median / High Price $68.80 / $92.09 / $195.56	Professional	$68.80	$92.09	$195.56