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Occupational Therapy Evaluation, Moderate Complexity

Iowa 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.

Facilitymedian $115 · 10th–90th $63$3470%10%10th90th$115Professionalmedian $98 · 10th–90th $63$3310%10%10th90th$98$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$181.97
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$91.20
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$109.65
Typical High
$154.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$134.90
Typical High
$245.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$109.65
Typical High
$467.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$281.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$288.40
Midlands
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$131.83
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$87.10
Typical High
$162.18
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$151.36