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Occupational Therapy Re-Evaluation

Utah rates for HCPCS 97168

This is a follow-up assessment by an occupational therapist to check a patient's progress on an existing treatment plan and adjust the goals or approach as needed. It is used when there has been a meaningful change in a patient's condition or function since the original evaluation.

Rates data updated October 2026.

How much does Occupational Therapy Re-Evaluation cost?

$57.54

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $57.54 for this service. The price depends on where it is billed: about $57.54 from a physician practice, and about $70.79 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$57.54$52.48 to $67.61
FacilityA hospital or hospital-owned outpatient department$70.79$56.23 to $100

How much rates vary

Facilitymedian $71 · 10th to 90th $56 to $120Professionalmedian $58 · 10th to 90th $48 to $74
$50$100facility $71professional $58

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
$56.23
Median
$56.23
Typical High
$56.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$56.23
Typical High
$57.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$81.28
Molina
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$56.23
Typical High
$67.61
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$100.00
Typical High
$125.89
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$74.13
Typical High
$83.18
Select Health
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Select Health
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$70.79
Typical High
$81.28
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$95.50
Typical High
$147.91
United
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$64.57
Typical High
$69.18
1 more rate 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
$27.54
Median
$27.54
Typical High
$27.54

Where Utah sits

The same service costs 3.0 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.

Utah· 32nd of 51

$57.54

AK $135FL $45.71

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.