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Occupational Therapy Evaluation, Moderate Complexity

Oklahoma 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?

$81.28

Typical negotiated rate. In Oklahoma, October 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $135 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$79.43$74.13 to $117
FacilityA hospital or hospital-owned outpatient department$135$97.72 to $182

How much rates vary

Facilitymedian $135 · 10th to 90th $76 to $224Professionalmedian $79 · 10th to 90th $65 to $129
$100$200$500facility $135professional $79

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
$60.26
Median
$74.13
Typical High
$128.82
Aetna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Ambetter
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
BCBS Oklahoma
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$147.91
Typical High
$229.09
BCBS Oklahoma
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$81.28
Typical High
$128.82
Cigna
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$75.86
Typical High
$97.72
Medica
Setting
Facility
Modifier
None
Typical Low
$69.18
Median
$83.18
Typical High
$177.83
Medica
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$85.11
Typical High
$630.96
United
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$81.28
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$79.43
Typical High
$93.33
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
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Ambetter
Setting
Professional
Modifier
GO · Occupational therapy plan
Typical Low
$75.86
Median
$75.86
Typical High
$95.50

Where Oklahoma 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.

Oklahoma· 35th of 51

$81.28

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.