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Physical Therapy Evaluation, High Complexity

Minnesota 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?

$123

Typical negotiated rate. In Minnesota, October 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $324 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$110$87.10 to $148
FacilityA hospital or hospital-owned outpatient department$324$245 to $380

How much rates vary

Facilitymedian $324 · 10th to 90th $132 to $537Professionalmedian $110 · 10th to 90th $83 to $251
$100$200$500facility $324professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$331.13
Typical High
$537.03
Aetna
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$93.33
Typical High
$107.15
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$162.18
Typical High
$302.00
BCBS Minnesota
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$138.04
Typical High
$263.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$218.78
Median
$288.40
Typical High
$575.44
Cigna
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$109.65
Typical High
$141.25
Health Partners
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$281.84
Typical High
$457.09
Health Partners
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$112.20
Medica
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$218.78
Typical High
$323.59
Medica
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$104.71
Typical High
$331.13
United
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$107.15
Typical High
$107.15
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$79.43
Typical High
$245.47
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$45.71
Typical High
$45.71

Where Minnesota 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.

Minnesota· 7th of 51

$123

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.