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Physical Therapy Evaluation, High Complexity

New Mexico 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?

$81.28

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $145 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$79.43$63.10 to $115
FacilityA hospital or hospital-owned outpatient department$145$95.50 to $661

How much rates vary

Facilitymedian $145 · 10th to 90th $76 to $1,096Professionalmedian $79 · 10th to 90th $49 to $309
$100.0$1.0K$10.0K$100.0Kfacility $145professional $79

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
$114.82
Median
$144.54
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$77.62
Typical High
$389.05
BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$707.95
Typical High
$1,230.27
BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$112.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$95.50
Typical High
$144.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$144.54
Providence
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$85.11
Typical High
$114.82
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$95.50
Typical High
$144.54
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$97.72
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$87.10
Typical High
$128.82

Where New Mexico 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.

New Mexico $81.28 · 26th 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.