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Physical Therapy Evaluation, High Complexity

South 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?

$97.72

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 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 8 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$97.72$70.79 to $120
FacilityA hospital or hospital-owned outpatient department$100$100 to $115

How much rates vary

Facilitymedian $100 · 10th to 90th $87 to $135Professionalmedian $98 · 10th to 90th $63 to $166
$100.0$200.0$500.0facility $100professional $98

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
$100.00
Median
$100.00
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$104.71
Avera
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$131.83
Avera
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$109.65
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$102.33
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$81.28
Typical High
$275.42
Midlands
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$125.89
Typical High
$141.25
Midlands
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$177.83
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$144.54
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$83.18
Typical High
$199.53
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$131.83
Typical High
$154.88

Where South 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.

South Dakota $97.72 · 15th 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.