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Physical Therapy Evaluation, High Complexity

Ohio 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?

$77.62

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $120 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 9 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$74.13$58.88 to $97.72
FacilityA hospital or hospital-owned outpatient department$120$93.33 to $166

How much rates vary

Facilitymedian $120 · 10th to 90th $59 to $251Professionalmedian $74 · 10th to 90th $50 to $145
$1.0$5.0$20.0$100.0$500.0facility $120professional $74

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
$58.88
Median
$107.15
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$66.07
Typical High
$141.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$89.13
Typical High
$151.36
Aultcare
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$131.83
Typical High
$131.83
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$75.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$97.72
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$141.25
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$83.18
Typical High
$154.88
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$234.42
Typical High
$478.63
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$83.18
Typical High
$147.91
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$79.43
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$104.71
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$97.72
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$114.82

Where Ohio 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.

Ohio $77.62 · 32nd 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.