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Occupational Therapy Evaluation, Moderate Complexity

Arizona 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?

$83.18

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $191 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 5 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$77.62$66.07 to $93.33
FacilityA hospital or hospital-owned outpatient department$191$93.33 to $331

How much rates vary

Facilitymedian $191 · 10th to 90th $71 to $417Professionalmedian $78 · 10th to 90th $59 to $166
$1.0$5.0$20.0$100.0$500.0facility $191professional $78

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
$239.88
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$74.13
Typical High
$165.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$234.42
Typical High
$467.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$57.54
Typical High
$81.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$93.33
Typical High
$158.49
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$147.91
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$89.13
Typical High
$120.23

Where Arizona 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.

Arizona $83.18 · 28th 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.