PT evaluation, high complexity cost in Madison, WI
In Madison, WI, 2 hospitals list a cash price for physical therapy evaluation, high complexity (typically about 45 minutes): from $274.30 to $531.94, with a median of $403.12. The lowest listed price is at Aspirus Divine Savior Hospital — $128.82 less than the median here. Across Wisconsin, the median is $274.30 at 46 hospitals.
Cash prices at 2 facilities across 2 cities for code 97163, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 23, 2026; the hospital files themselves were last updated between Jan 28, 2026 and Apr 1, 2026.
Where each hospital's price falls
Each dot is one hospital's cash price on a scale from the lowest to the highest in Madison, WI.
Hospitals, cheapest first
| Hospital | Cash price | List price | Insurers pay | Off list | File date |
|---|---|---|---|---|---|
| Aspirus Divine Savior Hospital lowest Portage, WI · (608) 742-4131 PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $274.30 | $422.00 | — | 35% | Apr 1, 2026 source file |
| Aspirus Divine Savior Hospital lowest Portage, WI · (608) 742-4131 Fac Physical Therapy Evaluation High Complex | $274.30 | $422.00 | — | 35% | Apr 1, 2026 source file |
| UnityPoint Health - Meriter Madison, WI · (608) 417-6210 HC PT EVAL HIGH COMPLEX | $531.94 | $664.92 | $95.13–$631.67 | 20% | Jan 28, 2026 source file |
Outpatient: lowest $274.30, median $403.12, highest $531.94 — a 1.9× difference within the same market.
As an inpatient, the same code is billed by 2 facilities here, median $403.12. 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 the one hospital here that publishes insurer rates for this code, the cash price is below the highest rate a health plan has negotiated. 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 high complexity, typically about 45 minutes face to face. It is used for an unstable or unpredictable problem, often with several other health conditions, such as after a major surgery or neurological illness.
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.