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Occupational Therapy Evaluation

Wisconsin rates for HCPCS 97003

The first appointment with an occupational therapist, in which they take a history, test how well you manage everyday tasks such as dressing, cooking, writing, and handling objects, and identify what is limiting you. The visit produces goals and a written plan for the therapy that follows.

Rates data updated July 2026.

How much does Occupational Therapy Evaluation cost?

$85.11

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $151 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$85.11$75.86 to $145
FacilityA hospital or hospital-owned outpatient department$151$85.11 to $251

How much rates vary

Facilitymedian $151 · 10th to 90th $66 to $295Professionalmedian $85 · 10th to 90th $68 to $813
$100$200$500facility $151professional $85

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$83.18
Typical High
$85.11
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$89.13
Typical High
$151.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$114.82
Typical High
$295.12
Medica
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$89.13
Typical High
$151.36
Quartz
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$295.12
Typical High
$295.12
Quartz
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$812.83
Typical High
$812.83

Where Wisconsin sits

The same service costs 398.1 times more in Kentucky than in Washington. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 23rd of 36

$85.11

KY $28,184WA $70.79

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.