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Physical Therapy Evaluation, High Complexity

Maryland 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 October 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$79.43

Typical physician fee. In Maryland, October 2026.

Insurers have agreed to pay about $79.43 for this service. Most negotiated rates run $74.13 to $87.10.

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 $102 · 10th to 90th $93 to $151Professionalmedian $79 · 10th to 90th $71 to $93
$100$200facility $102professional $79

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$93.33
Median
$102.33
Typical High
$151.36
Aetna
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$77.62
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$37.15
Median
$37.15
Typical High
$38.90
CareFirst
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$87.10
Typical High
$87.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$70.79
Typical High
$128.82
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$109.65
Typical High
$154.88
United
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$89.13
Typical High
$102.33
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$117.49

Where Maryland sits

The same service costs 3.3 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maryland· 35th of 51

$79.43

AK $200FL $60.26

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.