Tynbil: Know the *real* price for healthcare services

Rhode Island rates for HCPCS 97163

Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.87 / $75.87 / $522.16	Facility	$75.87	$75.87	$522.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.11 / $68.53 / $81.18	Professional	$49.11	$68.53	$81.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.20 / $198.38 / $234.86	Facility	$27.20	$198.38	$234.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $100.89 / $100.89	Professional	$70.62	$100.89	$100.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.53 / $85.64 / $100.71	Professional	$63.53	$85.64	$100.71
United Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $87.88 / $126.35	Professional	$65.61	$87.88	$126.35