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Physical Therapy Evaluation, High Complexity

Kentucky 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 Kentucky, 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 $81.28 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 6 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$58.88 to $74.13
FacilityA hospital or hospital-owned outpatient department$81.28$81.28 to $120

How much rates vary

Facilitymedian $81 · 10th to 90th $66 to $120Professionalmedian $66 · 10th to 90th $50 to $100
$50.0$100.0$200.0$500.0facility $81professional $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
$58.88
Median
$93.33
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$66.07
Typical High
$128.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$120.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$63.10
Typical High
$77.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$109.65
Typical High
$134.90
CareSource
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$109.65
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$162.18
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$104.71
Typical High
$467.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$48.98
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$75.86
Typical High
$109.65

Where Kentucky 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.

Kentucky $69.18 · 49th 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.