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Occupational Therapy Evaluation, Moderate Complexity

Kansas 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?

$105

Typical negotiated rate. In Kansas, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $107 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 5 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$105$77.62 to $105
FacilityA hospital or hospital-owned outpatient department$107$93.33 to $148

How much rates vary

Facilitymedian $107 · 10th to 90th $79 to $200Professionalmedian $105 · 10th to 90th $69 to $123
$50.0$100.0$200.0$500.0facility $107professional $105

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
$85.11
Median
$107.15
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$77.62
Typical High
$104.71
BCBS
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$112.20
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$123.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$64.57
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$91.20
Typical High
$177.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$93.33
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$91.20
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$147.91
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$83.18
Typical High
$120.23

Where Kansas 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.

Kansas $105 · 9th 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.