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Occupational Therapy Evaluation, Moderate Complexity

Louisiana 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?

$81.28

Typical negotiated rate. In Louisiana, July 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $72.44 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$72.44$63.10 to $85.11
FacilityA hospital or hospital-owned outpatient department$107$85.11 to $204

How much rates vary

Facilitymedian $107 · 10th to 90th $81 to $269Professionalmedian $72 · 10th to 90th $54 to $98
$50.0$100.0$200.0$500.0facility $107professional $72

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
$79.43
Median
$100.00
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$69.18
Typical High
$97.72
BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$165.96
Typical High
$263.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$93.33
Christus
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$72.44
Typical High
$223.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$87.10
Typical High
$134.90
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$79.43
Typical High
$93.33

Where Louisiana 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.

Louisiana $81.28 · 30th 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.