Doctor visits and therapy CPT 97161 Outpatient

PT evaluation, low complexity cost in Sheboygan, WI

In Sheboygan, WI, 2 hospitals list a cash price for physical therapy evaluation, low complexity (typically about 20 minutes): from $95.70 to $177.50, with a median of $136.60. The lowest listed price is at St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis — $40.90 less than the median here. Across Wisconsin, the median is $177.50 at 46 hospitals.

Cash prices at 2 facilities for code 97161, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 23, 2026; the hospital files themselves were last updated between Nov 21, 2025 and Nov 21, 2025.

Lowest$95.70St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis
Median$136.60half pay less
Highest$177.50in this market
Difference1.9×highest vs lowest

Where each hospital's price falls

Each dot is one hospital's cash price on a scale from the lowest to the highest in Sheboygan, WI.

median
Lowest $95.70Highest $177.50

Hospitals, cheapest first

HospitalCash price List priceInsurers payOff listFile date
St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis lowest Sheboygan, WI · (920) 459-8300 HC PT EVAL LOW COMPLEXITY 15MIN $95.70 $145.00 $70.47–$215.33 34% —
source file
St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis Sheboygan, WI · (920) 459-8300 HC PT EVAL LOW COMPLEXITY $99.00 $150.00 $72.90–$215.33 34% —
source file
St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis Sheboygan, WI · (920) 459-8300 HC PT EVAL LOW COMPLEXITY 30MIN $113.52 $172.00 $83.59–$215.33 34% —
source file
St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis Sheboygan, WI · (920) 459-8300 HC PT EVAL LOW COMPLEXITY 45MIN $124.08 $188.00 $88.79–$215.33 34% —
source file
St Nicholas Hospital of the Hospital Sisters of the Third Order of St Francis Sheboygan, WI · (920) 459-8300 HC PT EVAL LOW COMPLEXITY 60MIN $155.10 $235.00 $88.79–$235.00 34% —
source file
Aurora Medical Center Sheboygan County Sheboygan, WI · (920) 451-5000 PT EVAL LOW COMPLEXITY $177.50 $355.00 $213.00–$378.00 50% Nov 21, 2025
source file

Outpatient: lowest $95.70, median $136.60, highest $177.50 — a 1.9× difference within the same market.

As an inpatient, the same code is billed by 2 facilities here, median $136.60. Inpatient and outpatient prices are not comparable and are kept on separate pages: the inpatient charge covers admission, not the same purchase.

Cash or insurance?

At 2 of 2 hospitals that publish insurer rates for this code here, the cash price is below the highest rate a health plan has negotiated, and at 1 it is below every plan's rate. If you have insurance but have not met your deductible, you usually pay your plan's negotiated rate, which falls somewhere in the "Insurers pay" column. Paying cash can cost less, but a cash payment usually does not count toward your deductible. Ask the hospital for both numbers before you book.

What it is

This is a first physical therapy evaluation of low complexity, typically about 20 minutes face to face. It is used for a stable problem with few other health factors, and ends with a plan of care.

What the price covers

The price covers the evaluation, billed once per evaluation rather than in time units. Treatment on the same day, such as therapeutic exercise or manual therapy, is billed separately in 15-minute units.