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Physical Therapy Evaluation, High Complexity

Montana 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?

$105

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $170 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$95.50$75.86 to $158
FacilityA hospital or hospital-owned outpatient department$170$129 to $174

How much rates vary

Facilitymedian $170 · 10th to 90th $87 to $195Professionalmedian $95 · 10th to 90th $58 to $389
$100.0$1.0K$10.0K$100.0Kfacility $170professional $95

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
$234.42
Median
$234.42
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$446.68
Aetna
Setting
Professional
Modifier
CQ · PT assistant
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$109.65
Typical High
$158.49
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$169.82
Typical High
$177.83
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$169.82
Typical High
$177.83
Providence
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$87.10
Typical High
$186.21
Providence
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$102.33
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$87.10
Typical High
$138.04

Where Montana 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.

Montana $105 · 9th 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.