CPT 97163
The standard charge for PT Evaluation - High Complexity is $583.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
4643 Waimea Canyon Road, Waimea, HI, 96796CONTACT
808-338-9226 Visit WebsiteIn compliance with the Centers for Medicare and Medicaid Services (CMS) Final 2020 Price Transparency Rules, effective January 1, 2021, all hospitals in the United States annually must provide a machine-readable file containing negotiated charges (rates) for ALL items and services. Additionally, the rule requires that for 300 shoppable items and services only, hospitals must provide a consumer-friendly display of gross charge and negotiated charges (rates) or estimation tool.
The fees and/or costs provided via this tool are only estimates, and your final bill may be higher or lower than the estimate for various reasons including but not limited to differences in the number of conditions among patients having the same or similar primary procedures, differences in physician ordering practices, unforeseen complications, etc. Moreover, this is not a guarantee of your benefit plan coverage or payment, and the actual payer and patient portion reflected in your final bill may also be higher or lower.
In some instances, where no recent historical claims and/or payment information is available for the payer plan and the item or service you have selected, the estimate may be for the base rate only or not available. Consequently, the estimate may exclude estimates for additional charges and payer payments for services billed in conjunction with the item or service you selected.
Also, this estimate DOES NOT include other services billed for separately by other providers including but not limited to physician or practitioner fees such as pathologist, radiologist, anesthesiologist, physician surgeon or assistant surgeon, etc. If you have questions about your individual situation or were unable to find an estimate for your upcoming service, please contact us at 808-338-9226.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$9.91Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$23.84Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$204.05Price Negotiated by Insurer
$378.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$129.3597530 PT Therapeutic Activity Assistant Units
$159.90Basic Metabolic Panel (BMP) FSI
$76.05Blood Glucose Monitoring POC
$23.40CBC Complete Blood Count w/ Diff FSI
$74.10Comprehensive Metabolic Panel (CMP) FSI
$91.65Magnesium Urine Timed FSI
$61.10pantoprazole 40mg vial [HHSC]
$12.88Phosphorus FSI
$43.55This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$262.35Price Negotiated by Insurer
$320.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$109.4597530 PT Therapeutic Activity Assistant Units
$135.30Basic Metabolic Panel (BMP) FSI
$64.35Blood Glucose Monitoring POC
$19.80CBC Complete Blood Count w/ Diff FSI
$62.70Comprehensive Metabolic Panel (CMP) FSI
$77.55Magnesium Urine Timed FSI
$51.70pantoprazole 40mg vial [HHSC]
$21.39Phosphorus FSI
$36.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$19.45Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$29.15Price Negotiated by Insurer
$553.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$189.0597530 PT Therapeutic Activity Assistant Units
$233.70Basic Metabolic Panel (BMP) FSI
$8.46Blood Glucose Monitoring POC
$3.28CBC Complete Blood Count w/ Diff FSI
$7.77Comprehensive Metabolic Panel (CMP) FSI
$10.56Magnesium Urine Timed FSI
$6.70pantoprazole 40mg vial [HHSC]
$36.95Phosphorus FSI
$4.74This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$87.45Price Negotiated by Insurer
$495.55Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$169.1597530 PT Therapeutic Activity Assistant Units
$209.10Basic Metabolic Panel (BMP) FSI
$99.45Blood Glucose Monitoring POC
$30.60CBC Complete Blood Count w/ Diff FSI
$96.90Comprehensive Metabolic Panel (CMP) FSI
$119.85Magnesium Urine Timed FSI
$79.90pantoprazole 40mg vial [HHSC]
$33.06Phosphorus FSI
$56.95This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$19.45Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$58.30Price Negotiated by Insurer
$524.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$179.1097530 PT Therapeutic Activity Assistant Units
$221.40Basic Metabolic Panel (BMP) FSI
$105.30Blood Glucose Monitoring POC
$32.40CBC Complete Blood Count w/ Diff FSI
$102.60Comprehensive Metabolic Panel (CMP) FSI
$126.90Magnesium Urine Timed FSI
$84.60pantoprazole 40mg vial [HHSC]
$17.84Phosphorus FSI
$60.30This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$285.67Price Negotiated by Insurer
$297.33Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$101.4997530 PT Therapeutic Activity Assistant Units
$125.46Basic Metabolic Panel (BMP) FSI
$59.67Blood Glucose Monitoring POC
$18.36CBC Complete Blood Count w/ Diff FSI
$58.14Comprehensive Metabolic Panel (CMP) FSI
$71.91Magnesium Urine Timed FSI
$47.94pantoprazole 40mg vial [HHSC]
$10.11Phosphorus FSI
$34.17This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$23.84Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$17.49Price Negotiated by Insurer
$565.51Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$193.0397530 PT Therapeutic Activity Assistant Units
$238.62Basic Metabolic Panel (BMP) FSI
$113.49Blood Glucose Monitoring POC
$34.92CBC Complete Blood Count w/ Diff FSI
$110.58Comprehensive Metabolic Panel (CMP) FSI
$136.77Magnesium Urine Timed FSI
$91.18pantoprazole 40mg vial [HHSC]
$37.73Phosphorus FSI
$64.99This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$19.45Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$19.45Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$476.30Price Negotiated by Insurer
$106.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$17.6597530 PT Therapeutic Activity Assistant Units
$18.32Basic Metabolic Panel (BMP) FSI
$11.70Blood Glucose Monitoring POC
$2.50CBC Complete Blood Count w/ Diff FSI
$10.74Comprehensive Metabolic Panel (CMP) FSI
$14.61Magnesium Urine Timed FSI
$9.26pantoprazole 40mg vial [HHSC]
$23.34Phosphorus FSI
$6.56This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$291.50Price Negotiated by Insurer
$291.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$99.5097530 PT Therapeutic Activity Assistant Units
$123.00Basic Metabolic Panel (BMP) FSI
$58.50Blood Glucose Monitoring POC
$18.00CBC Complete Blood Count w/ Diff FSI
$57.00Comprehensive Metabolic Panel (CMP) FSI
$70.50Magnesium Urine Timed FSI
$47.00pantoprazole 40mg vial [HHSC]
$19.45Phosphorus FSI
$33.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.
Total estimated charges
$583.00Insurance Discount
-$158.05Price Negotiated by Insurer
$424.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
97110 - Theurapeutic Proc Ea 15 min
$145.0597530 PT Therapeutic Activity Assistant Units
$179.31Basic Metabolic Panel (BMP) FSI
$21.89Blood Glucose Monitoring POC
$4.68CBC Complete Blood Count w/ Diff FSI
$20.09Comprehensive Metabolic Panel (CMP) FSI
$27.32Magnesium Urine Timed FSI
$17.32pantoprazole 40mg vial [HHSC]
$37.23Phosphorus FSI
$12.27This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kauai Veterans Memorial Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kauai Veterans Memorial Hospital directly at 808-338-9226.