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Occupational Therapy Evaluation, Moderate Complexity

Washington, DC 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?

$77.62

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $77.62 for this service. Most negotiated rates run $74.13 to $145.

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.

How much rates vary

Facilitymedian $263 · 10th to 90th $78 to $363Professionalmedian $78 · 10th to 90th $55 to $112
$50.0$200.0$1.0K$5.0Kfacility $263professional $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
$77.62
Median
$263.03
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$75.86
Typical High
$77.62
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$165.96
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$79.43
Typical High
$239.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$234.42

Where Washington, DC 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.

Washington, DC $77.62 · 33rd 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.