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Physical Therapy Evaluation, High Complexity

Missouri 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?

$83.18

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $81.28 from a physician practice, and about $107 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$81.28$66.07 to $162
FacilityA hospital or hospital-owned outpatient department$107$75.86 to $151

How much rates vary

Facilitymedian $107 · 10th to 90th $71 to $288Professionalmedian $81 · 10th to 90th $52 to $372
$50.0$100.0$200.0$500.0facility $107professional $81

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
$70.79
Median
$107.15
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$457.09
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$54.95
Typical High
$144.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$162.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$79.43
Typical High
$186.21
Medica
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$95.50
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$83.18
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$144.54
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$131.83

Where Missouri 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.

Missouri $83.18 · 21st 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.