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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 July 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$69.18

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $69.18 for this service. The price depends on where it is billed: about $66.07 from a physician practice, and about $151 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$66.07$56.23 to $81.28
FacilityA hospital or hospital-owned outpatient department$151$83.18 to $209

How much rates vary

Facilitymedian $151 · 10th to 90th $49 to $295Professionalmedian $66 · 10th to 90th $49 to $98
$50.0$100.0$200.0$500.0facility $151professional $66

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
$50.12
Median
$151.36
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$66.07
Typical High
$95.50
AvMed
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$79.43
Typical High
$97.72
AvMed
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$97.72
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$54.95
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$72.44
Typical High
$138.04
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$177.83
Typical High
$181.97
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$67.61
Typical High
$85.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$97.72
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$66.07
Typical High
$107.15
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$100.00

Where Florida 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.

Florida $69.18 · 48th 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.