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Occupational Therapy Evaluation, Moderate Complexity

New Hampshire 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?

$102

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $112 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$77.62 to $148
FacilityA hospital or hospital-owned outpatient department$112$61.66 to $170

How much rates vary

Facilitymedian $112 · 10th to 90th $62 to $380Professionalmedian $100 · 10th to 90th $60 to $219
$50.0$100.0$200.0facility $112professional $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
$61.66
Median
$112.20
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$64.57
Typical High
$95.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$100.00
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$93.33
Typical High
$204.17
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$162.18
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$218.78
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$89.13
Typical High
$123.03
Well Sense
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88

Where New Hampshire 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.

New Hampshire $102 · 10th 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.