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Occupational Therapy Evaluation, High Complexity

Colorado rates for HCPCS 97167

This is a thorough evaluation performed by an occupational therapist to assess a patient's ability to perform daily activities, such as dressing, cooking, or work tasks, when the patient's condition involves multiple complicating factors. It typically includes a detailed history, standardized assessments, and clinical judgment to develop a treatment plan for a patient with a more complex presentation than a routine evaluation. This level reflects more time and clinical complexity than a basic evaluation.

Rates data updated October 2026.

How much does Occupational Therapy Evaluation, High Complexity cost?

$85.11

Typical negotiated rate. In Colorado, October 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $110 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$85.11$70.79 to $93.33
FacilityA hospital or hospital-owned outpatient department$110$89.13 to $135

How much rates vary

Facilitymedian $110 · 10th to 90th $89 to $178Professionalmedian $85 · 10th to 90th $65 to $126
$100$200facility $110professional $85

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$114.82
Typical High
$177.83
Aetna
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$89.13
Typical High
$89.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$32.36
Median
$44.67
Typical High
$44.67
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$77.62
Typical High
$117.49
Cigna
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$61.66
Typical High
$120.23
Denver HMP
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$89.13
Typical High
$128.82
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$125.89
Typical High
$177.83
Select Health
Setting
Facility
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$218.78
Select Health
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$109.65
Typical High
$144.54
United
Setting
Facility
Modifier
None
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$93.33
Typical High
$102.33

Where Colorado 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.

Colorado· 30th of 51

$85.11

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.