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Occupational Therapy Evaluation, Moderate Complexity

Minnesota 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?

$148

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $263 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 6 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$145$91.20 to $275
FacilityA hospital or hospital-owned outpatient department$263$145 to $437

How much rates vary

Facilitymedian $263 · 10th to 90th $93 to $479Professionalmedian $145 · 10th to 90th $74 to $288
$50.0$100.0$200.0$500.0$1.0Kfacility $263professional $145

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
$91.20
Median
$91.20
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$165.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$234.42
Typical High
$1,047.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$234.42
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$371.54
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$112.20
Typical High
$177.83
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$436.52
Typical High
$467.74
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$141.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$199.53
Typical High
$331.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$144.54
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$309.03

Where Minnesota 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.

Minnesota $148 · 3rd 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.