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Occupational Therapy Evaluation, Moderate Complexity

Alaska rates for HCPCS 97166

An occupational therapist assesses how a health condition, injury, or developmental issue is affecting a person's ability to perform everyday tasks like dressing, cooking, or working, then creates a plan of care. This version reflects a moderately complex case, with a somewhat more involved health history and a moderate number of areas affecting daily function compared to a more straightforward evaluation.

Rates data updated July 2026.

How much does Occupational Therapy Evaluation, Moderate Complexity cost?

$182

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $126 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$186$85.11 to $275
FacilityA hospital or hospital-owned outpatient department$126$85.11 to $200

How much rates vary

Facilitymedian $126 · 10th to 90th $74 to $331Professionalmedian $186 · 10th to 90th $68 to $339
$100$200$500facility $126professional $186

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$331.13
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$83.18
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$109.65
Typical High
$295.12
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$199.53
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$275.42
Typical High
$457.09
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$165.96
Typical High
$3,467.37
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$177.83
Typical High
$338.84
Providence
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$199.53
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$107.15
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$239.88
Typical High
$269.15

Where Alaska sits

The same service costs 2.8 times more in Alaska than in Delaware. 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.

Alaska· 1st of 51

$182

AK $182DE $66.07

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.