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Occupational Therapy Evaluation, Moderate Complexity

Florida 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?

$69.18

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $69.18 for this service. The price depends on where it is billed: about $69.18 from a physician practice, and about $162 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$69.18$58.88 to $83.18
FacilityA hospital or hospital-owned outpatient department$162$83.18 to $263

How much rates vary

Facilitymedian $162 · 10th to 90th $52 to $295Professionalmedian $69 · 10th to 90th $52 to $98
$50.0$100.0$200.0$500.0facility $162professional $69

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
$52.48
Median
$162.18
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$67.61
Typical High
$95.50
AvMed
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$81.28
Typical High
$102.33
AvMed
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$97.72
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$54.95
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$72.44
Typical High
$134.90
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$181.97
Typical High
$186.21
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$69.18
Typical High
$89.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$100.00
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$66.07
Typical High
$102.33
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$102.33

Where Florida 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.

Florida $69.18 · 50th 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.