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Maryland rates for HCPCS 97164

Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $98 · 10th–90th $51–$3390%20%10th90th$98Professionalmedian $54 · 10th–90th $37–$1450%20%10th90th$54$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $97.72 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $53.70 / $147.91
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $57.54 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $57.54 / $97.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $63.10 / $77.62
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $75.86 / $109.65