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Physical Therapy Evaluation, High Complexity

Georgia 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?

$77.62

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $95.50 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$77.62$66.07 to $95.50
FacilityA hospital or hospital-owned outpatient department$95.50$70.79 to $182

How much rates vary

Facilitymedian $95 · 10th to 90th $66 to $282Professionalmedian $78 · 10th to 90th $56 to $148
$1.0$10.0$100.0$1.0Kfacility $95professional $78

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
$66.07
Median
$95.50
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$75.86
Typical High
$158.49
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$85.11
Typical High
$138.04
CareSource
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$97.72
Typical High
$128.82
CareSource
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$81.28
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$114.82
Typical High
$275.42
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$131.83
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$138.04

Where Georgia 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.

Georgia $77.62 · 35th 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.