go back

Physical Therapy Evaluation, High Complexity

Florida 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?

$60.26

Typical negotiated rate. In Florida, October 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $60.26 from a physician practice, and about $178 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$60.26$48.98 to $72.44
FacilityA hospital or hospital-owned outpatient department$178$100 to $182

How much rates vary

Facilitymedian $178 · 10th to 90th $55 to $186Professionalmedian $60 · 10th to 90th $40 to $98
$50$100$200facility $178professional $60

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$46.77
Median
$112.20
Typical High
$295.12
Aetna
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$48.98
Typical High
$83.18
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$23.44
Median
$24.55
Typical High
$33.11
AvMed
Setting
Facility
Modifier
None
Typical Low
$79.43
Median
$97.72
Typical High
$100.00
AvMed
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$95.50
Typical High
$102.33
Cigna
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$162.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$69.18
Typical High
$75.86
Florida Blue
Setting
Facility
Modifier
None
Typical Low
$64.57
Median
$177.83
Typical High
$186.21
Florida Blue
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$61.66
Typical High
$67.61
Molina
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$109.65
Typical High
$239.88
United
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$97.72
Typical High
$97.72
United
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$54.95
Typical High
$69.18
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$97.72
Typical High
$97.72
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Ambetter
Setting
Professional
Modifier
GP · Physical therapy plan
Typical Low
$48.98
Median
$77.62
Typical High
$79.43

Where Florida 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.

Florida· 51st of 51

$60.26

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.