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Occupational Therapy Evaluation, Moderate Complexity

Colorado 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?

$79.43

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $110 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 7 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$74.13$63.10 to $93.33
FacilityA hospital or hospital-owned outpatient department$110$89.13 to $178

How much rates vary

Facilitymedian $110 · 10th to 90th $78 to $389Professionalmedian $74 · 10th to 90th $54 to $115
$2.0$10.0$50.0$200.0facility $110professional $74

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
$89.13
Median
$169.82
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$74.13
Typical High
$114.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$97.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$67.61
Typical High
$134.90
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$95.50
Typical High
$162.18
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$162.18
Typical High
$407.38
Select Health
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$208.93
Typical High
$218.78
Select Health
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$144.54
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$109.65
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$104.71

Where Colorado 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.

Colorado $79.43 · 31st 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.