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Occupational Therapy Evaluation, Low Complexity

South Carolina rates for HCPCS 97165

An occupational therapist assesses how a health condition, injury, or developmental issue affects a person's ability to manage everyday tasks like dressing, bathing, or working, then puts together a plan of care. This version applies to more straightforward cases, where the health history and the number of affected daily activities are relatively limited.

Rates data updated July 2026.

Facilitymedian $100 · 10th–90th $66$2880%10%20%10th90th$100Professionalmedian $76 · 10th–90th $60$1910%20%10th90th$76$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$74.13
Typical High
$190.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$194.98
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$66.07
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$74.13
Typical High
$107.15
Medcost
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$85.11
Typical High
$138.04
Medcost
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$100.00
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$100.00