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Occupational Therapy Evaluation, Moderate Complexity

Missouri 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?

$83.18

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $77.62 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 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$77.62$67.61 to $123
FacilityA hospital or hospital-owned outpatient department$107$77.62 to $155

How much rates vary

Facilitymedian $107 · 10th to 90th $71 to $288Professionalmedian $78 · 10th to 90th $52 to $282
$50.0$100.0$200.0$500.0facility $107professional $78

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
$70.79
Median
$107.15
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$316.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$57.54
Typical High
$144.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$107.15
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$77.62
Typical High
$194.98
Medica
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$97.72
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$87.10
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$114.82
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$83.18
Typical High
$134.90

Where Missouri 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.

Missouri $83.18 · 26th 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.