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Occupational Therapy Evaluation, Moderate Complexity

Idaho 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?

$95.50

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $95.50 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $120 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 8 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$93.33$83.18 to $123
FacilityA hospital or hospital-owned outpatient department$120$100 to $162

How much rates vary

Facilitymedian $120 · 10th to 90th $89 to $234Professionalmedian $93 · 10th to 90th $68 to $178
$50.0$100.0$200.0facility $120professional $93

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
$95.50
Median
$117.49
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$91.20
Typical High
$165.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$151.36
Typical High
$223.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$194.98
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$141.25
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$181.97
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$223.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$147.91
Select Health
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$117.49
Typical High
$234.42
Select Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$107.15
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$93.33

Where Idaho 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.

Idaho $95.50 · 15th 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.