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Physical Therapy Evaluation, High Complexity

South Carolina 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?

$72.44

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $72.44 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 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$72.44$64.57 to $83.18
FacilityA hospital or hospital-owned outpatient department$100$70.79 to $186

How much rates vary

Facilitymedian $100 · 10th to 90th $71 to $295Professionalmedian $72 · 10th to 90th $56 to $98
$50.0$100.0$200.0$500.0facility $100professional $72

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
$70.79
Median
$85.11
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$70.79
Typical High
$97.72
BCBS
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$194.98
Typical High
$398.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$53.70
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$54.95
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$70.79
Typical High
$107.15
Medcost
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$83.18
Typical High
$138.04
Medcost
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$97.72
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$77.62
Typical High
$100.00

Where South Carolina 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.

South Carolina $72.44 · 44th 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.