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Occupational Therapy Evaluation, Moderate Complexity

Alabama 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?

$72.44

Typical negotiated rate. In Alabama, July 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $83.18 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 4 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$70.79$63.10 to $89.13
FacilityA hospital or hospital-owned outpatient department$83.18$47.86 to $100

How much rates vary

Facilitymedian $83 · 10th to 90th $41 to $100Professionalmedian $71 · 10th to 90th $52 to $100
$50.0$100.0$200.0$500.0facility $83professional $71

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
$83.18
Median
$100.00
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$69.18
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$45.71
Typical High
$61.66
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$95.50
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$64.57
Typical High
$70.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$77.62
Typical High
$93.33
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$81.28
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$104.71

Where Alabama sits

The same service costs 2.8 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Alabama $72.44 · 48th of 51
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.