Physical therapy evaluation (high complexity) Cost

Physical therapy evaluation (high complexity) is a therapy or rehabilitation service. Prices are from 2286 US hospitals across 52 states, from their machine-readable files.

$263median cash price · 2286 hospitals, 52 statestypically $106–$677 depending on the hospital
≈ 2.7× Medicare · On the higher sideFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$441
Cash / self-pay
$263
Insurer-negotiated
$170
Medicare pays
$98
$106$677
Median cash $263  ·  Medicare $98  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $263 — about 2.7× the Medicare rate ($98). On the higher side. A fair cash price is usually within ~2× Medicare ($196).

💡 Asking for the cash price instead of the $441 list price could save about $179 (40%).

Estimate what you’ll pay
Quick fill:

Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
Winn Parish Medical Center Winnfield, LA $42 $93 — 100 min 14.5%
Ochsner LSU Health Monroe Monroe, LA $42 $92 ★ 3/5 155 min 15.2%
Advocate Trinity Hospital Chicago, IL $43 $225 ★ 2/5 244 min 16.0%
East Jefferson General Hospital Metairie, LA $44 $74 ★ 2/5 162 min 15.3%
Banner Payson Medical Center Payson, AZ $45 $97 ★ 4/5 143 min 14.4%
Bayamon Medical Center Bayamon, PR $45 $20 — 285 min 15.8%
Ochsner St Mary Morgan City, LA $47 $95 ★ 2/5 81 min 15.4%
Ochsner LSU Health Shreveport-St Mary Medical Cent Shreveport, LA $47 $95 ★ 2/5 — —
Banner-University Medical Center South Campus Tucson, AZ $49 $148 ★ 4/5 275 min 14.5%
King's Daughters Medical Center-Brookhaven Brookhaven, MS $49 $123 ★ 3/5 136 min 15.3%
Clarke County Hospital Osceola, IA $50 $65 ★ 5/5 104 min 14.8%
Virtua Our Lady of Lourdes Hospital Camden, NJ $50 — ★ 2/5 161 min 15.4%
Virtua Willingboro Hospital Willingboro, NJ $50 — ★ 3/5 181 min 14.8%
Eisenhower Medical Center Rancho Mirage, CA $51 $103 ★ 4/5 259 min 14.8%
Hamilton Medical Center Dalton, GA $52 — ★ 3/5 187 min 15.3%
Baptist Health Medical Center Heber Springs Heber Springs, AR $52 $175 ★ 3/5 115 min 15.2%
Baptist Health Medical Center-Arkadelphia Arkadelphia, AR $52 $175 — 95 min 15.2%
Tanner Medical Center-East Alabama Wedowee, AL $53 $65 — 94 min 14.6%
Parkwest Medical Center Knoxville, TN $55 $183 ★ 3/5 259 min 14.9%
Bsa Hospital Amarillo, TX $55 $384 ★ 2/5 217 min 14.8%
Oklahoma Spine Hospital Oklahoma City, OK $55 $91 — 110 min 13.1%
University of Kansas Hospital Kansas City, KS $56 $256 ★ 5/5 307 min 14.1%
Cumberland Medical Center Crossville, TN $56 $156 ★ 4/5 201 min 15.1%
Morristown Hamblen Hospital Association Morristown, TN $56 $156 ★ 2/5 199 min 15.7%
Roane Medical Center Harriman, TN $56 $156 ★ 4/5 174 min 15.5%

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated June 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Physical therapy evaluation (high complexity)

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $263; Medicare pays $98.

InsurerHospitalsNegotiated median
Univera 10
$84
$83 – $111
Medicaid 293
$89
$59 – $198
Tricare / VA 384
$90
$84 – $283
Independent Health 44
$91
$51 – $194
Devoted Health 199
$96
$84 – $188
Medicare 507
$97
$89 – $190
Amerigroup 158
$98
$46 – $423
Highmark 113
$98
$86 – $357
Centene / Ambetter 718
$101
$62 – $210
Humana 918
$102
$84 – $415
Molina Healthcare 499
$103
$60 – $220
AmeriHealth 227
$109
$59 – $430
Priority Health 49
$111
$66 – $392
Bright Health 49
$121
$89 – $260
UCare 59
$148
$85 – $343
Oscar Health 203
$151
$96 – $287
Anthem 495
$153
$59 – $451
Security Health Plan 56
$158
$95 – $420
MVP Health Care 82
$170
$87 – $407
UnitedHealthcare 1429
$171
$86 – $449
Aetna 1315
$180
$89 – $421
UPMC Health Plan 67
$196
$94 – $494
Geisinger 60
$201
$85 – $470
Blue Cross Blue Shield 1214
$207
$93 – $508
HealthPartners 241
$211
$91 – $383
Medica 230
$215
$101 – $353
SelectHealth 45
$217
$94 – $373
Sanford Health Plan 66
$222
$100 – $362
Cigna 1093
$247
$97 – $563
Healthcare Highways 40
$249
$147 – $428
EmblemHealth 58
$254
$111 – $386
Kaiser Permanente 155
$273
$101 – $1,052
Workers' Comp / No-Fault 141
$274
$80 – $678
Harvard Pilgrim 47
$284
$146 – $393
Health Net 277
$286
$108 – $703
AvMed 58
$293
$100 – $691
Coventry 136
$296
$94 – $506
MultiPlan / PHCS network 809
$361
$173 – $702

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Puerto Rico$45
Mississippi$115
Alabama$122
Tennessee$129
Arizona$130
Oklahoma$136

Prices by city

Chicago, ILPhiladelphia, PABaltimore, MDAustin, TXDallas, TXHouston, TXCincinnati, OHNew York, NYBrooklyn, NYKansas City, MOOklahoma City, OKSan Antonio, TXBaton Rouge, LABronx, NYCharlotte, NCFort Worth, TXMilwaukee, WINashville, TNOmaha, NESaint Louis, MOAlbuquerque, NMBirmingham, ALEl Paso, TXLos Angeles, CA

Prices by state

TexasCaliforniaOhioFloridaPennsylvaniaNew YorkWisconsinIllinoisNorth CarolinaMinnesotaMichiganLouisianaGeorgiaTennesseeIowaMissouriColoradoNebraskaOklahomaIndianaVirginiaNew JerseyArkansasMarylandKentuckyKansasSouth DakotaArizonaWashingtonMississippiMassachusettsWest VirginiaMaineAlabamaSouth CarolinaNorth DakotaMontanaOregonIdahoNew MexicoNew HampshireUtahConnecticutNevadaHawaiiWyomingVermontDelawareRhode IslandAlaskaPuerto RicoWashington DC

About these prices

Based on prices published by 2286 US hospitals across 52 states, the typical (median) cash price is $263, versus a chargemaster (list) price around $441, a median insurer-negotiated rate of $170, a Medicare rate of about $98. Most cash prices fall between $106 and $677 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Physical therapy evaluation (high complexity) cost without insurance?
The median cash (self-pay) price across 2286 US hospitals is $263. Most hospitals fall between $106 and $677. Prices vary widely between hospitals, so it pays to compare before you book.
What does Medicare pay for Physical therapy evaluation (high complexity)?
Medicare pays about $98. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Physical therapy evaluation (high complexity) prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

Related Therapy & Rehab

Physical therapy evaluationPhysical therapy evaluation (moderate complexity)Occupational therapy evaluationOccupational therapy evaluation (low complexity)Speech therapyOccupational therapy evaluation (moderate complexity)Occupational therapy evaluation (high complexity)Cardiac rehabilitation

See more Therapy & Rehab.