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Physical Therapy Evaluation, High Complexity

Indiana 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 Indiana, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $200 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 5 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$74.13$58.88 to $87.10
FacilityA hospital or hospital-owned outpatient department$200$93.33 to $309

How much rates vary

Facilitymedian $200 · 10th to 90th $71 to $437Professionalmedian $74 · 10th to 90th $55 to $120
$50.0$100.0$200.0$500.0facility $200professional $74

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
$74.13
Median
$239.88
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$70.79
Typical High
$102.33
Aetna
Setting
Professional
Modifier
CQ · PT assistant
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$81.28
Typical High
$102.33
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$79.43
Typical High
$141.25
CareSource
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$104.71
Typical High
$128.82
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$112.20
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$95.50
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$93.33
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$107.15
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$79.43
Typical High
$125.89

Where Indiana 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.

Indiana $77.62 · 33rd 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.