Physical therapy evaluation (moderate complexity) Cost

Physical therapy evaluation (moderate complexity) is a therapy or rehabilitation service. Prices are from 2367 US hospitals across 52 states, from their machine-readable files.

$234median cash price · 2367 hospitals, 52 statestypically $100–$577 depending on the hospital

≈ 2.4× Medicare · On the higher sideFind hospitals near you

Price comparison (median)

Chargemaster (list price)

$385

Cash / self-pay

$234

Insurer-negotiated

$163

Medicare pays

$98

$100$577

Median cash $234 · Medicare $98 · bar = typical cash range (10th–90th percentile)

Is this a fair price?

1× Medicarefair ≈2×5×+

Typical cash price here is $234 — about 2.4× 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 $385 list price could save about $151 (39%).

Estimate what you’ll pay

Deductible remaining Coinsurance %

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

See negotiated rates for your insurer:

Hospital	Location	Cash	Insurer	CMS rating	ER wait	Readmit
Banner Payson Medical Center	Payson, AZ	$35	$77	★ 4/5	143 min	14.4%
University of Ks Hlth System Great Bend Campus	Great Bend, KS	$40	$121	★ 4/5	107 min	14.5%
Winn Parish Medical Center	Winnfield, LA	$42	$93	—	100 min	14.5%
Banner-University Medical Center South Campus	Tucson, AZ	$42	$127	★ 4/5	275 min	14.5%
Ochsner LSU Health Monroe	Monroe, LA	$42	$92	★ 3/5	155 min	15.2%
Bayamon Medical Center	Bayamon, PR	$43	$20	—	285 min	15.8%
East Jefferson General Hospital	Metairie, LA	$44	$74	★ 2/5	162 min	15.3%
Seton Medical Center Harker Heights	Harker Heights, TX	$46	$179	★ 4/5	174 min	16.3%
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	—	—
Clinch Memorial Hospital	Homerville, GA	$48	$91	—	93 min	—
Slidell Memorial Hospital	Slidell, LA	$49	$92	★ 2/5	203 min	16.0%
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%
Bsa Hospital	Amarillo, TX	$50	$349	★ 2/5	217 min	14.8%
Saint Vincent Hospital	Erie, PA	$51	$97	★ 4/5	212 min	14.7%
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-Arkadelphia	Arkadelphia, AR	$52	$175	—	95 min	15.2%
Baptist Health Medical Center Heber Springs	Heber Springs, AR	$52	$175	★ 3/5	115 min	15.2%
Sabine Medical Center	Many, LA	$53	$93	—	128 min	15.4%
Tanner Medical Center-East Alabama	Wedowee, AL	$53	$65	—	94 min	14.6%
University Medical Center of El Paso	El Paso, TX	$53	$116	★ 3/5	242 min	15.4%

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 August 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 (moderate 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: $234; Medicare pays $98.

Insurer	Hospitals	Negotiated median
Univera	10	$84 $83 – $111
Medicaid	310	$89 $59 – $173
Tricare / VA	402	$91 $84 – $297
Independent Health	46	$91 $58 – $172
Highmark	117	$96 $84 – $299
Devoted Health	212	$96 $84 – $188
Medicare	529	$98 $89 – $171
Amerigroup	160	$98 $45 – $383
Centene / Ambetter	740	$101 $56 – $197
Humana	976	$101 $83 – $374
Molina Healthcare	531	$102 $60 – $208
AmeriHealth	241	$109 $59 – $444
Priority Health	54	$111 $66 – $293
Bright Health	49	$117 $89 – $222
Security Health Plan	59	$150 $94 – $299
Anthem	529	$151 $62 – $415
Oscar Health	220	$151 $90 – $267
UCare	67	$155 $81 – $287
UnitedHealthcare	1499	$160 $84 – $405
MVP Health Care	83	$170 $87 – $407
UPMC Health Plan	80	$180 $94 – $457
Aetna	1384	$180 $87 – $395
SelectHealth	44	$187 $94 – $373
Sanford Health Plan	66	$189 $98 – $310
HealthPartners	260	$200 $95 – $358
Blue Cross Blue Shield	1266	$202 $91 – $509
Medica	246	$204 $99 – $327
Healthcare Highways	40	$224 $119 – $389
Cigna	1142	$227 $96 – $491
EmblemHealth	58	$230 $111 – $340
Kaiser Permanente	158	$241 $98 – $1,002
Geisinger	61	$241 $85 – $470
AvMed	60	$243 $101 – $498
Health Net	279	$255 $103 – $648
Workers' Comp / No-Fault	148	$257 $80 – $581
Coventry	150	$257 $94 – $422
Harvard Pilgrim	50	$276 $132 – $376
MultiPlan / PHCS network	849	$331 $163 – $582

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

State	Median cash
Puerto Rico	$43
Mississippi	$115
Tennessee	$115
Arizona	$123
Alabama	$123
Oklahoma	$124

Prices by city

Prices by state

Doctors who perform this

Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.

Clinician	Specialty	Location	Medicare services
Spencer Clark	Physical Therapist in Private Practice	Salt Lake City, UT	2,193
Ahson Mahfooz, PT, DPT	Physical Therapist in Private Practice	Brooklyn, NY	821
Darrel Elwell	Physical Therapist in Private Practice	Roswell, NM	671
Elizabeth Owens, DPT	Physical Therapist in Private Practice	Columbus, OH	662
Tami Peavy, PT	Physical Therapist in Private Practice	Alhambra, CA	589
John Gaminde	Physical Therapist in Private Practice	Richmond Hill, NY	559
Juan Nunez, P.T.	Physical Therapist in Private Practice	Palmetto Bay, FL	513
Mary Jean Endozo, PT	Physical Therapist in Private Practice	Plainfield, NJ	511
Fernando Orlino	Physical Therapist in Private Practice	San Diego, CA	461
David Anthony, PHYSICAL THERAPIST	Physical Therapist in Private Practice	Port Charlotte, FL	461
Nicholas Maly	Physical Therapist in Private Practice	Santa Barbara, CA	457
Mohamed Afify, PT	Physical Therapist in Private Practice	Brooklyn, NY	432

Browse doctors by specialty & city →

Does Medicare cover Physical therapy evaluation (moderate complexity)?

Yes — Medicare generally covers Physical therapy evaluation (moderate complexity). It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $98. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $20 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 2367 US hospitals across 52 states, the typical (median) cash price is $234, versus a chargemaster (list) price around $385, a median insurer-negotiated rate of $163, a Medicare rate of about $98. Most cash prices fall between $100 and $577 — 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 (moderate complexity) cost without insurance?

The median cash (self-pay) price across 2367 US hospitals is $234. Most hospitals fall between $100 and $577. Prices vary widely between hospitals, so it pays to compare before you book.

Does Medicare cover Physical therapy evaluation (moderate complexity)?

Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $98). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.

What does Medicare pay for Physical therapy evaluation (moderate 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 (moderate 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 evaluation Physical therapy evaluation (high complexity)Occupational therapy evaluation Occupational therapy evaluation (low complexity)Speech therapy Occupational therapy evaluation (moderate complexity)Occupational therapy evaluation (high complexity)Cardiac rehabilitation

See more Therapy & Rehab.