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Physical Therapy Evaluation, High Complexity

Hawaii 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?

$97.72

Typical physician fee. In Hawaii, July 2026.

Insurers have agreed to pay about $97.72 for this service. Most negotiated rates run $81.28 to $126.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $135 · 10th to 90th $65 to $135Professionalmedian $95 · 10th to 90th $63 to $155
$50.0$100.0$200.0facility $135professional $95

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. 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
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$97.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$102.33
Typical High
$131.83
HMSA
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$120.23
Typical High
$147.91
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$120.23
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$100.00
Typical High
$141.25
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$125.89
Typical High
$186.21

Where Hawaii 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.

Hawaii $97.72 · 13th 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.