Why is the price range for Physical Therapy Evaluation, Low Complexity so wide?

Hospitals negotiate differently with different insurers, the procedure can be performed in different settings (hospital outpatient, ambulatory, inpatient), and in-network status varies plan-by-plan. The 2.1× spread between the 25th and 75th percentile in the data reflects those structural differences, not clinical ones.

What's the cash price for Physical Therapy Evaluation, Low Complexity if I don't have insurance?

The median discounted cash price across reporting Colorado hospitals is $257. Hospitals are required to offer a self-pay rate that's often less than the gross "chargemaster" charge but typically more than the lowest negotiated rate — the per-hospital table on this page shows the full spread.

What does CPT 97161 mean?

CPT 97161 is the CPT (Current Procedural Terminology) code for Physical Therapy Evaluation, Low Complexity. It identifies the procedure for billing and price-disclosure purposes — every hospital's MRF reports rates against this code.

Physical Therapy Evaluation, Low Complexity

CPT 9716138 Colorado hospitals reporting

Initial physical therapy evaluation, low complexity. Frequently the entry point for outpatient PT after orthopedic surgery, falls, or chronic pain.

Typical insured price · Colorado

$127to$261

What hospitals actually accept from insurers, between the 25th and 75th percentile — half of negotiated rates fall in this window with a median of $177.

$127$261

Cash price (median)

$257

What you'd pay self-pay

Gross charge (median)

$437

The chargemaster sticker

vs Medicare

—

Coming with enrichment

Sourced from 38 Colorado hospitals publishing under 45 CFR §180.50.

At a glance

Code: CPT 97161
Code system: CPT (Current Procedural Terminology)
Typical setting: an outpatient setting
Hospitals reporting: 38

How they price Physical Therapy Evaluation, Low Complexity

Across 38 Colorado hospitals that publish a commercial negotiated rate for CPT 97161, the typical insured price for Physical Therapy Evaluation, Low Complexity runs $127 to $261 (the 25th-to-75th percentile of per-hospital medians). The Colorado median is $177 — half of reporting hospitals are at or below that figure. The median discounted cash price across the same hospitals is $257, against a median gross charge of $437.

What affects the price

Structural and contractual factors that move the price for this code — not clinical reasons.

· Outpatient setting (hospital outpatient department, ambulatory surgery center, or office) is the single biggest non-clinical price driver — the same code in a hospital outpatient department often costs 2–4× the ambulatory-surgery-center rate.
· In-network vs out-of-network status — out-of-network claims rarely use the negotiated rates shown here.
· Facility fee — many hospitals add a separate facility fee in addition to the procedure rate; ask explicitly when calling.
· Bundled vs unbundled billing — the rate may or may not include radiology read, anaesthesia, or pathology. Ask which professional services are included.

Where to get it

Sorted by median negotiated rate, low to high. The bar shows each hospital’s position in the Colorado range.

39 hospitals

Pin a plan

Plans named by their MRF label. Confirm in-network status with your insurer before scheduling.

Hospitals reporting rates for this procedure, ranked by median negotiated price.
Hospital	Position · Median	Negotiated band	Cash	Payers
Hca Healthone Presbyterian St Luke S Medical Center Median negotiated $93 25th–75th $89 – $101 Cash — Payers 16	$93	$89 – $101	—	16
Hca Healthone Swedish Medical Center Median negotiated $97 25th–75th $89 – $101 Cash — Payers 14	$97	$89 – $101	—	14
Hca Healthone Sky Ridge Medical Center Median negotiated $97 25th–75th $89 – $101 Cash — Payers 15	$97	$89 – $101	—	15
Hca Healthone Aurora Medical Center of Aurora Median negotiated $97 25th–75th $89 – $101 Cash — Payers 14	$97	$89 – $101	—	14
Hca Healthone Rose Medical Center Median negotiated $97 25th–75th $89 – $101 Cash — Payers 15	$97	$89 – $101	—	15
Lincoln Community Hospital Hugo Gross charge $219 Median negotiated $101 25th–75th $101 – $101 Cash $219 Payers 14	$101	$101 – $101	$219	14
Valley View Hospital Glenwood Springs Gross charge $162 Median negotiated $101 25th–75th $101 – $101 Cash $138 Payers 3	$101	$101 – $101	$138	3
Community Hospital Grand Junction Gross charge $312 Median negotiated $103 25th–75th $101 – $112 Cash $175 Payers 7	$103	$101 – $112	$175	7
Uchealth Parkview Medical Center Pueblo Gross charge $224 Median negotiated $120 25th–75th $101 – $221 Cash $90 Payers 12	$120	$101 – $221	$90	12
National Jewish Health Denver Gross charge $193 Median negotiated $125 25th–75th $102 – $145 Cash $135 Payers 8	$125	$102 – $145	$135	8
Commonspirit St Francis Hospital Gross charge $761 Median negotiated $131 25th–75th $101 – $190 Cash $305 Payers 15	$131	$101 – $190	$305	15
Commonspirit St Francis Hospital Interquest Gross charge $761 Median negotiated $131 25th–75th $99 – $202 Cash $305 Payers 14	$131	$99 – $202	$305	14
Commonspirit St Anthony North Hospital Gross charge $761 Median negotiated $137 25th–75th $101 – $207 Cash $305 Payers 16	$137	$101 – $207	$305	16
Commonspirit Orthocolorado Hospital Gross charge $761 Median negotiated $137 25th–75th $101 – $199 Cash $305 Payers 15	$137	$101 – $199	$305	15
Commonspirit St Anthony Hospital Lakewood Gross charge $761 Median negotiated $153 25th–75th $99 – $212 Cash $305 Payers 14	$153	$99 – $212	$305	14
Denver Health Medical Center Gross charge $315 Median negotiated $155 25th–75th $108 – $235 Cash $110 Payers 7	$155	$108 – $235	$110	7
Pikes Peak Regional Hospital Woodland Park Gross charge $197 Median negotiated $156 25th–75th $90 – $167 Cash $158 Payers 12	$156	$90 – $167	$158	12
Uchealth Yampa Valley Medical Center Steamboat Springs Gross charge $196 Median negotiated $158 25th–75th $145 – $184 Cash $176 Payers 12	$158	$145 – $184	$176	12
Commonspirit Longmont United Hospital Gross charge $761 Median negotiated $166 25th–75th $101 – $217 Cash $305 Payers 15	$166	$101 – $217	$305	15
Commonspirit St Anthony Summit Medical Center Gross charge $313 Median negotiated $188 25th–75th $101 – $270 Cash $125 Payers 14	$188	$101 – $270	$125	14
Uchealth Greeley Hospital Gross charge $367 Median negotiated $195 25th–75th $101 – $257 Cash $220 Payers 12	$195	$101 – $257	$220	12
Uchealth Grandview Hospital Colorado Springs Gross charge $437 Median negotiated $213 25th–75th $149 – $257 Cash $153 Payers 13	$213	$149 – $257	$153	13
Uchealth Highlands Ranch Hospital Gross charge $437 Median negotiated $220 25th–75th $154 – $262 Cash $131 Payers 12	$220	$154 – $262	$131	12
Commonspirit Mercy Hospital Durango Gross charge $342 Median negotiated $223 25th–75th $101 – $291 Cash $137 Payers 16	$223	$101 – $291	$137	16
Uchealth Medical Center of the Rockies Loveland Gross charge $367 Median negotiated $227 25th–75th $111 – $302 Cash $257 Payers 16	$227	$111 – $302	$257	16
Uchealth Poudre Valley Hospital Fort Collins Gross charge $367 Median negotiated $227 25th–75th $108 – $302 Cash $257 Payers 16	$227	$108 – $302	$257	16
Uchealth Longs Peak Hospital Longmont Gross charge $437 Median negotiated $229 25th–75th $154 – $295 Cash $153 Payers 14	$229	$154 – $295	$153	14
Commonspirit St Thomas More Hospital Ca on City Gross charge $323 Median negotiated $257 25th–75th $67 – $278 Cash $129 Payers 14	$257	$67 – $278	$129	14
Uchealth Memorial Hospital North Colorado Springs Gross charge $571 Median negotiated $262 25th–75th $208 – $329 Cash $257 Payers 14	$262	$208 – $329	$257	14
Uchealth Memorial Hospital Central Colorado Springs Gross charge $571 Median negotiated $262 25th–75th $208 – $329 Cash $257 Payers 14	$262	$208 – $329	$257	14
Commonspirit St Mary Corwin Hospital Pueblo Gross charge $806 Median negotiated $263 25th–75th $99 – $407 Cash $322 Payers 14	$263	$99 – $407	$322	14
Uchealth University of Colorado Hospital Aurora Gross charge $851 Median negotiated $279 25th–75th $172 – $428 Cash $298 Payers 15	$279	$172 – $428	$298	15
Children S Hospital Colorado Colorado Springs Gross charge $431 Median negotiated $283 25th–75th $238 – $321 Cash $280 Payers 33	$283	$238 – $321	$280	33
Family Health West Hospital Fruita Median negotiated $371 25th–75th $371 – $371 Cash — Payers 1	$371	$371 – $371	—	1
Boulder Community Health Foothills Hospital Gross charge $870 Median negotiated $373 25th–75th $111 – $735 Cash $435 Payers 31	$373	$111 – $735	$435	31
Uchealth Estes Valley Medical Center Estes Park Gross charge $467 Median negotiated $420 25th–75th $229 – $444 Cash $350 Payers 15	$420	$229 – $444	$350	15
Commonspirit St Elizabeth Hospital Fort Morgan Gross charge $760 Median negotiated $591 25th–75th $101 – $714 Cash $304 Payers 12	$591	$101 – $714	$304	12
Grand River Health Rifle Gross charge $354 Median negotiated $903 25th–75th $903 – $903 Cash $177 Payers 1	$903	$903 – $903	$177	1
Prowers Medical Center Lamar Gross charge $486 Median negotiated — 25th–75th — Cash $292 Payers —	—	—	$292	—

Common questions

Short answers, derived from the data on this page. See the full FAQ for site-wide questions.

What is the typical price for Physical Therapy Evaluation, Low Complexity in Colorado?: Across 38 Colorado hospitals reporting a commercial negotiated rate for CPT 97161, the 25th-to-75th percentile band runs $127 to $261 per hospital median. The 50th-percentile (Colorado median) is $177.
Why is the price range for Physical Therapy Evaluation, Low Complexity so wide?: Hospitals negotiate differently with different insurers, the procedure can be performed in different settings (hospital outpatient, ambulatory, inpatient), and in-network status varies plan-by-plan. The 2.1× spread between the 25th and 75th percentile in the data reflects those structural differences, not clinical ones.
What's the cash price for Physical Therapy Evaluation, Low Complexity if I don't have insurance?: The median discounted cash price across reporting Colorado hospitals is $257. Hospitals are required to offer a self-pay rate that's often less than the gross "chargemaster" charge but typically more than the lowest negotiated rate — the per-hospital table on this page shows the full spread.
What does CPT 97161 mean?: CPT 97161 is the CPT (Current Procedural Terminology) code for Physical Therapy Evaluation, Low Complexity. It identifies the procedure for billing and price-disclosure purposes — every hospital's MRF reports rates against this code.

Browse related collections

The same procedure shows up under several useful lenses. Each collection groups it with peers that get shopped together.