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Occupational Therapy Evaluation, Moderate Complexity

Oregon 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?

$135

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $123 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 8 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$123$79.43 to $209
FacilityA hospital or hospital-owned outpatient department$174$115 to $204

How much rates vary

Facilitymedian $174 · 10th to 90th $91 to $251Professionalmedian $123 · 10th to 90th $66 to $288
$50$100$200$500facility $174professional $123

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
$114.82
Median
$251.19
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$316.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$75.86
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$263.03
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$208.93
Typical High
$257.04
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$109.65
Typical High
$194.98
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$251.19
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$204.17
Providence
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$199.53
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$251.19
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$331.13
Typical High
$407.38
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$109.65
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$181.97

Where Oregon 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.

Oregon· 6th of 51

$135

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.