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Occupational Therapy Evaluation, Moderate Complexity

Hawaii 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?

$100

Typical physician fee. In Hawaii, July 2026.

Insurers have agreed to pay about $100 for this service. Most negotiated rates run $83.18 to $126.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $138 · 10th to 90th $65 to $138Professionalmedian $100 · 10th to 90th $72 to $158
$50.0$100.0$200.0facility $138professional $100

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$83.18
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$109.65
Typical High
$128.82
HMSA
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$117.49
Typical High
$147.91
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$128.82
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$102.33
Typical High
$147.91
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$123.03
Typical High
$186.21

Where Hawaii 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.

Hawaii $100 · 11th 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.