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

Molina pricing summary

Low

Average

$160

Median

$131

High

$2.1k

Molina rate distribution

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1,073 hospital rates

#		Plans
1	The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges	1	$189	$166	$29	18%	641	$121 – $189
2	St. Joseph Medical Center Bellingham, WA facility · other · outpatient	2	$106	$98	$17	17%	594	$61 – $106
3	PeaceHealth Southwest Medical Center Vancouver, WA facility · other · outpatient	3	$61	$73	$32	44%	417	$40 – $108
4	HARTFORD HOSPITAL HARTFORD, CT other · outpatient	1	$103	$103	—	—	219	$103 – $103
5	HARTFORD HOSPITAL HARTFORD, CT case rate · outpatient	2	$249	$249	$10	4%	143	$239 – $258
6	Upstate University Hospital Syracuse, NY facility · case rate · outpatient	2	$196	$196	$73	37%	131	$123 – $269
7	STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient	2	$132	$132	$48	36%	114–123	$84 – $180
8	Self Regional Healthcare Greenwood, SC facility · other · outpatient	2	$106	$106	$11	11%	106	$94 – $117
9	Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges	1	$97	$96	$2	2%	75	$92 – $97
10	HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT SOUTHINGTON, CT other · outpatient	1	$103	$103	—	—	62	$103 – $103
11	SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT case rate · outpatient	2	$217	$217	$9	4%	54–63	$208 – $225
12	Richland Memorial Hospital Inc Olney, IL percent of total billed charges · outpatientfrom % of charges	2	$88	$88	$16	18%	52–97	$71 – $107
13	PeaceHealth United General Medical Center Sedro Woolley, WA facility · other · outpatient	1	$109	$109	—	—	50	$109 – $109
14	STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient	1	$196	$196	—	—	48	$196 – $196
15	Bexar County Hospital District San Antonio, TX other · outpatient	1	$142	$142	—	—	46	$142 – $142
16	Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both	2	$114	$113	$2	1%	42–60	$111 – $115
17	Adena Health System Chillicothe, OH facility · other · outpatient	1	$107	$107	—	—	40	$107 – $107
18	THE WILLIAM W BACKUS HOSPITAL PLAINFIELD, CT other · outpatient	1	$103	$103	—	—	40	$103 – $103
19	BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges	1	$67	$67	—	—	38	$67 – $67
20	The University of Texas Southwestern Medical Center at Dallas Dallas, TX percent of total billed charges · outpatientfrom % of charges	1	$78	$78	—	—	37	$78 – $78
21	Valley County Hospital NE 68862-1240; 400 S 23rd St Ord, NE facility · percent of total billed charges · outpatientfrom % of charges	2	$179	$179	$2	1%	35	$178 – $181
22	Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges	1	$67	$65	$3	4%	32	$60 – $67
23	SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT other · outpatient	1	$103	$103	—	—	32	$103 – $103
24	Adena Fayette Medical Center Washington Court House, OH facility · other · outpatient	2	$177	$177	—	—	28	$177 – $177
25	HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT SOUTHINGTON, CT case rate · outpatient	2	$249	$249	$10	4%	26–35	$239 – $258

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CPT 97162