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Occupational Therapy Evaluation, Low Complexity

Utah 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 $85 · 10th–90th $85$1450%50%90th$85Professionalmedian $93 · 10th–90th $60$3470%10%20%10th90th$93$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
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$89.13
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$93.33
Typical High
$190.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$229.09
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$181.97
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$120.23
Select Health
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$120.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$117.49
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$138.04
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$102.33