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Occupational Therapy Evaluation, Moderate Complexity

North Dakota 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?

$166

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $91.20 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$170$89.13 to $224
FacilityA hospital or hospital-owned outpatient department$91.20$91.20 to $155

How much rates vary

Facilitymedian $91 · 10th to 90th $85 to $182Professionalmedian $170 · 10th to 90th $68 to $263
$50$100$200$500facility $91professional $170

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
$181.97
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$91.20
Typical High
$165.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$114.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$109.65
Typical High
$229.09
Medica
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$91.20
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$91.20
Typical High
$229.09

Where North Dakota sits

The same service costs 2.8 times more in Alaska than in Delaware. 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.

North Dakota· 2nd of 51

$166

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.