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Occupational Therapy Evaluation, Moderate Complexity

Mississippi 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 October 2026.

How much does Occupational Therapy Evaluation, Moderate Complexity cost?

$85.11

Typical negotiated rate. In Mississippi, October 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $87.10 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$85.11$63.10 to $95.50
FacilityA hospital or hospital-owned outpatient department$87.10$87.10 to $87.10

How much rates vary

Facilitymedian $87 · 10th to 90th $87 to $132Professionalmedian $85 · 10th to 90th $33 to $132
$50$100facility $87professional $85

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$44.67
Median
$131.83
Typical High
$154.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$131.83
Typical High
$147.91
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$31.62
Median
$66.07
Typical High
$74.13
BCBS Mississippi
Setting
Facility
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
BCBS Mississippi
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$66.07
Typical High
$109.65
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
None
Typical Low
$91.20
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$75.86
Typical High
$89.13
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Ambetter
Setting
Professional
Modifier
GO · Occupational therapy plan
Typical Low
$74.13
Median
$93.33
Typical High
$93.33
Ambetter
Setting
Professional
Modifier
GP · Physical therapy plan
Typical Low
$93.33
Median
$93.33
Typical High
$93.33

Where Mississippi sits

The same service costs 3.3 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Mississippi· 28th of 51

$85.11

AK $200FL $60.26

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.