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Physical Therapy Evaluation, High Complexity

North Dakota 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?

$100

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $100 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 5 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$77.62 to $219
FacilityA hospital or hospital-owned outpatient department$100$87.10 to $148

How much rates vary

Facilitymedian $100 · 10th to 90th $87 to $245Professionalmedian $95 · 10th to 90th $59 to $257
$50.0$100.0$200.0$500.0facility $100professional $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
$87.10
Median
$100.00
Typical High
$245.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$77.62
Typical High
$162.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$112.20
Medica
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$100.00
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$77.62
Typical High
$173.78
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$239.88

Where North Dakota 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.

North Dakota $100 · 12th 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.