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Occupational Therapy Evaluation, Moderate Complexity

Montana 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 Montana, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $174 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$120$83.18 to $158
FacilityA hospital or hospital-owned outpatient department$174$132 to $178

How much rates vary

Facilitymedian $174 · 10th to 90th $89 to $195Professionalmedian $120 · 10th to 90th $68 to $316
$100.0$1.0K$10.0K$100.0Kfacility $174professional $120

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
$302.00
Median
$302.00
Typical High
$302.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$89.13
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$112.20
Typical High
$158.49
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$181.97
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$181.97
Providence
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$89.13
Typical High
$190.55
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$104.71
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$131.83

Where Montana 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.

Montana $148 · 5th 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.