Physical therapy evaluation, moderate complexity

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

MODERATE COMPLEXITY PT EVALUATION

Payers reporting CPT 97162

Payer pricing summary

Low

$83

Average

$723

Median

$226

High

$10.2k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +36 other terms	627	$99	$141	$143	102%	1,474–1,492	$1 – $1.8k
2	Kaiser fee schedule · outpatient · +24 other terms	96	$134	$175	$155	89%	262	$1 – $1.6k
3	Humana fee schedule · outpatient · +33 other terms	443	$96	$129	$130	101%	207–234	$1 – $1.2k
4	Aetna fee schedule · outpatient · +37 other terms	648	$102	$208	$132	64%	174–210	$1 – $1.3k
5	Bcbs In fee schedule · both	11	$188	$188	$1	0%	139–193	$187 – $189
6	Molina fee schedule · outpatient · +31 other terms	225	$132	$135	$82	61%	117–153	$1 – $1.4k
7	Anthem fee schedule · outpatient · +33 other terms	173	$103	$112	$101	90%	106–124	$45 – $937
8	Blue Cross Blue Shield fee schedule · outpatient · +35 other terms	483	$141	$210	$143	68%	78–105	$1 – $3.4k
9	Tricare facility · fee schedule · outpatient · +19 other terms	117	$94	$98	$51	52%	62	$77 – $1.0k
10	Cigna fee schedule · outpatient · +33 other terms	266	$129	$226	$112	50%	43–79	$58 – $1.8k
11	Bcbs Al facility · other · outpatient · +4 other terms	5	$53	$55	$6	10%	38	$47 – $62
12	Sanford Health Plan fee schedule · outpatient · +17 other terms	15	$97	$115	$59	51%	15	$97 – $374
13	WellCare fee schedule · outpatient · +25 other terms	279	$95	$96	$11	11%	3–30	$38 – $171
14	Caresource fee schedule · outpatient · +21 other terms	87	$105	$161	$43	27%	2–20	$1 – $279
15	Aetna Better Health fee schedule · outpatient · +18 other terms	55	$76	$95	$39	41%	2–20	$50 – $238
16	Bcbs Tn facility · percent of total billed charges · outpatientfrom % of charges	1	$561	$561	$1	0%	2–20	$560 – $562
17	Medicare fee schedule · both · +15 other terms	62	$95	$109	$10	9%	1–10	$85 – $135
18	Optum fee schedule · outpatient · +23 other terms	61	$95	$123	$59	48%	1–10	$84 – $363
19	Wellmark facility · fee schedule · both · +23 other terms	32	$123	$200	$142	71%	1–10	$52 – $657
20	Baylor Scott White Health Plan facility · fee schedule · both · +1 other terms	1	$113	$113	—	—	1–10	$113 – $113
21	Bcbs Mt fee schedule · inpatient · +2 other terms	1	$157	$157	—	—	1–10	$157 – $157
22	Devoted fee schedule · outpatient · +17 other terms	170	$92	$92	$6	7%	—	$81 – $105
23	Cigna Healthspring fee schedule · outpatient · +9 other terms	133	$97	$94	$6	7%	—	$84 – $113
24	Ambetter facility · fee schedule · outpatient · +21 other terms	102	$164	$149	$39	26%	—	$98 – $303
25	MultiPlan fee schedule · outpatient · +21 other terms	73	$217	$236	$151	64%	—	$1 – $743

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