Physical Therapy Evaluation, Low Complexity

CPT 9716138 Colorado hospitals reporting a negotiated rate

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 of per-hospital medians — half of reporting hospitals’ median 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, anesthesia, 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 listed

Medians shown combine all commercial payers; your plan's rate may differ. Choose your insurance carrier to filter.

Choose your insurance carrier

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

0 of 3 hospitals selected

Pick up to 3 hospitals from the table to compare.

Prices by metro: Denver MetroColorado SpringsFort CollinsBoulderRest of Colorado

What to do next

Ask the hospital for a Good Faith Estimate — under the federal No Surprises Act, hospitals must give uninsured and self-pay patients a written estimate for scheduled care. If you're insured, ask your insurer for your expected cost-sharing in advance, confirm the hospital is in-network, and bring your insurance card.

Know your rights under the No Surprises Act (CMS) →

Common questions

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

How much does Physical Therapy Evaluation, Low Complexity cost in Colorado?

Across 38 Colorado hospitals that publish a commercial negotiated rate, the median is $177. The middle half of hospitals fall between $127 and $261 — the 25th-to-75th percentile of per-hospital medians.

Is the doctor's fee included in these prices?

Usually not. These rates are the hospital's facility charge — the room, equipment, and hospital staff. The physician who treats you or reads your results often bills separately for their professional fee. Ask the practice whether professional fees are billed separately before you schedule.

Does insurance change what I'd pay?

Yes. The negotiated rate depends on which insurer and plan you have, and what you actually pay depends on your deductible, coinsurance, and whether the hospital is in your network. Colorado hospitals publish negotiated rates for Physical Therapy Evaluation, Low Complexity under 97 different payer names. Verify coverage with your insurer before scheduling. Choose your insurance carrier above the hospital table to see per-insurer rates.

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 publish any discounted cash price they offer self-pay patients — 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.

Is this a price quote?

No. These are rates hospitals have published under the federal price-transparency rule — they show what insurers have negotiated, not what you will be billed. Your bill depends on your plan, deductible, in-network status, and clinical circumstances. Verify the price with the hospital and confirm coverage with your insurer before scheduling.

What are my rights if the bill doesn't match?

If you're uninsured or paying cash, the federal No Surprises Act gives you the right to a written Good Faith Estimate before scheduled care — and if the final bill is at least $400 over that estimate, you can dispute it. Most insured patients are also protected from surprise bills for emergency care and certain out-of-network care at in-network facilities.

Know your rights under the No Surprises Act (CMS) →

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 machine-readable file 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.