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Occupational Therapy Evaluation, Moderate Complexity

Nebraska 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?

$112

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $191 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$100$89.13 to $214
FacilityA hospital or hospital-owned outpatient department$191$158 to $219

How much rates vary

Facilitymedian $191 · 10th to 90th $98 to $309Professionalmedian $100 · 10th to 90th $72 to $331
$50.0$100.0$200.0$500.0facility $191professional $100

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
$154.88
Median
$194.98
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$97.72
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$151.36
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$151.36
Typical High
$234.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$186.21
Typical High
$275.42
Medica
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$154.88
Typical High
$257.04
Midlands
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$213.80
Midlands
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$112.20
Typical High
$234.42
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$91.20
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$218.78

Where Nebraska 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.

Nebraska $112 · 7th 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.