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Occupational Therapy Evaluation, Moderate Complexity

Utah 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.

Facilitymedian $85 · 10th–90th $85$1450%50%90th$85Professionalmedian $85 · 10th–90th $56$3160%10%10th90th$85$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$85.11
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$93.33
Typical High
$190.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$229.09
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$181.97
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$120.23
Select Health
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$120.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$117.49
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$138.04
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$102.33