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Occupational Therapy Evaluation, High Complexity

Hawaii 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?

$129

Typical physician fee. In Hawaii, October 2026.

Insurers have agreed to pay about $129 for this service. Most negotiated rates run $110 to $135.

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.

How much rates vary

Professionalmedian $129 · 10th to 90th $93 to $135
$100professional $129

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
Professional
Modifier
None
Typical Low
$58.88
Median
$83.18
Typical High
$120.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
HMSA
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$109.65
Typical High
$117.49
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$117.49
Typical High
$128.82
United
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$128.82
Typical High
$128.82

Where Hawaii 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.

Hawaii· 7th of 51

$129

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.