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Physical Therapy Evaluation, High Complexity

Iowa 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 negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $112 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 8 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$97.72$70.79 to $245
FacilityA hospital or hospital-owned outpatient department$112$95.50 to $186

How much rates vary

Facilitymedian $112 · 10th to 90th $63 to $347Professionalmedian $98 · 10th to 90th $63 to $457
$50.0$100.0$200.0$500.0facility $112professional $98

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
$63.10
Median
$181.97
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$97.72
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$112.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$158.49
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$131.83
Typical High
$234.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$112.20
Typical High
$457.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$112.20
Typical High
$263.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$302.00
Midlands
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Midlands
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$125.89
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$83.18
Typical High
$173.78
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$147.91

Where Iowa 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.

Iowa $97.72 · 14th 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.