Tynbil: Know the *real* price for healthcare services

Vermont 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 Professional Modifier Low / Median / High Price $58.45 / $90.66 / $444.70	Professional	$58.45	$90.66	$444.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $287.50 / $309.72 / $346.87	Facility	$287.50	$309.72	$346.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.32 / $106.65 / $369.93	Professional	$88.32	$106.65	$369.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.14 / $85.64 / $101.29	Professional	$64.14	$85.64	$101.29
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $64.14 / $86.23 / $101.29	Professional	$64.14	$86.23	$101.29
United Facility/Professional Professional Modifier Low / Median / High Price $81.69 / $116.79 / $221.02	Professional	$81.69	$116.79	$221.02