Occupational therapy evaluation (low complexity) Cost

Occupational therapy evaluation (low complexity) is a therapy or rehabilitation service. Prices are from 2256 US hospitals across 52 states, from their machine-readable files.

$212median cash price · 2256 hospitals, 52 statestypically $95–$510 depending on the hospital
≈ 2.1× Medicare · On the higher sideFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$355
Cash / self-pay
$212
Insurer-negotiated
$157
Medicare pays
$101
$95$510
Median cash $212  ·  Medicare $101  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $212 — about 2.1× the Medicare rate ($101). On the higher side. A fair cash price is usually within ~2× Medicare ($201).

💡 Asking for the cash price instead of the $355 list price could save about $143 (40%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
University of Ks Hlth System Great Bend Campus Great Bend, KS $33 $98 ★ 4/5 107 min 14.5%
Banner-University Medical Center Tucson Campus Tucson, AZ $37 $117 ★ 3/5 306 min 14.6%
Lakeland Regional Medical Center Lakeland, FL $39 $1,150 ★ 1/5 162 min 16.7%
Slidell Memorial Hospital Slidell, LA $41 $95 ★ 2/5 203 min 16.0%
Hamilton Medical Center Dalton, GA $42 — ★ 3/5 187 min 15.3%
East Jefferson General Hospital Metairie, LA $44 $72 ★ 2/5 162 min 15.3%
Ochsner LSU Health Monroe Monroe, LA $44 $95 ★ 3/5 155 min 15.2%
Bsa Hospital Amarillo, TX $45 $317 ★ 2/5 217 min 14.8%
Banner-University Medical Center South Campus Tucson, AZ $46 $120 ★ 4/5 275 min 14.5%
Baptist Health Medical Center Heber Springs Heber Springs, AR $46 $148 ★ 3/5 115 min 15.2%
Baptist Health Medical Center-Arkadelphia Arkadelphia, AR $46 $166 — 95 min 15.2%
Luminis Health J Kent McNew Family Medical Center Annapolis, MD $49 — — — —
West Jefferson Medical Center Marrero, LA $49 $84 ★ 3/5 154 min 15.0%
Elbert Memorial Hospital Elberton, GA $50 $74 — 120 min 15.0%
Clarke County Hospital Osceola, IA $50 $68 ★ 5/5 104 min 14.8%
Virtua Our Lady of Lourdes Hospital Camden, NJ $50 — ★ 2/5 161 min 15.4%
Virtua Willingboro Hospital Willingboro, NJ $50 — ★ 3/5 181 min 14.8%
Banner-University Medical Center Phoenix Phoenix, AZ $50 $165 ★ 3/5 265 min 14.9%
Community Hospital Torrington, WY $50 $165 ★ 2/5 120 min 14.8%
Tanner Medical Center-East Alabama Wedowee, AL $50 $65 — 94 min 14.6%
Unity Health-Jacksonville Jacksonville, AR $51 — — 130 min 15.2%
Unity Health-Newport Newport, AR $51 — — 104 min 15.4%
King's Daughters Medical Center-Brookhaven Brookhaven, MS $51 $126 ★ 3/5 136 min 15.3%
University Medical Center of El Paso El Paso, TX $52 $116 ★ 3/5 242 min 15.4%
Eisenhower Medical Center Rancho Mirage, CA $52 $106 ★ 4/5 259 min 14.8%

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated June 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Occupational therapy evaluation (low complexity)

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $212; Medicare pays $101.

InsurerHospitalsNegotiated median
Medicaid 288
$90
$61 – $164
Independent Health 43
$92
$62 – $240
Tricare / VA 391
$93
$90 – $268
Amerigroup 151
$98
$58 – $427
Devoted Health 197
$98
$86 – $107
Medicare 508
$99
$89 – $218
Univera 9
$99
$84 – $112
Humana 922
$102
$86 – $377
Molina Healthcare 499
$103
$60 – $213
Centene / Ambetter 705
$103
$55 – $210
Highmark 119
$105
$85 – $315
AmeriHealth 229
$106
$56 – $450
Geisinger 61
$108
$83 – $431
UCare 65
$115
$83 – $277
Bright Health 49
$124
$92 – $221
Priority Health 50
$126
$68 – $258
Oscar Health 198
$144
$87 – $256
Anthem 490
$145
$59 – $390
UPMC Health Plan 66
$147
$97 – $398
Security Health Plan 56
$155
$95 – $273
MVP Health Care 79
$158
$92 – $369
UnitedHealthcare 1418
$162
$88 – $413
SelectHealth 43
$164
$96 – $332
Aetna 1300
$175
$86 – $387
HealthPartners 248
$185
$90 – $336
Sanford Health Plan 64
$186
$99 – $305
AvMed 58
$186
$93 – $364
Blue Cross Blue Shield 1209
$191
$92 – $431
Medica 241
$199
$101 – $343
Health Net 266
$212
$99 – $641
Cigna 1086
$213
$96 – $491
EmblemHealth 56
$230
$100 – $334
Kaiser Permanente 155
$242
$101 – $812
Healthcare Highways 37
$250
$128 – $525
Coventry 140
$250
$95 – $475
Workers' Comp / No-Fault 142
$273
$95 – $627
Harvard Pilgrim 47
$287
$120 – $401
MultiPlan / PHCS network 805
$313
$152 – $618

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Arizona$95
Oklahoma$109
Tennessee$110
Mississippi$110
Arkansas$121
Alabama$122

Prices by city

Chicago, ILPhiladelphia, PABaltimore, MDAustin, TXDallas, TXHouston, TXCincinnati, OHNew York, NYKansas City, MOBaton Rouge, LABronx, NYBrooklyn, NYCharlotte, NCFort Worth, TXLos Angeles, CANashville, TNSacramento, CASaint Louis, MOSan Antonio, TXAlbuquerque, NMBirmingham, ALBoston, MAEl Paso, TXMiami, FL

Prices by state

TexasCaliforniaOhioFloridaPennsylvaniaIllinoisNew YorkWisconsinMinnesotaNorth CarolinaMichiganGeorgiaTennesseeLouisianaMissouriColoradoIowaNebraskaIndianaVirginiaSouth DakotaKentuckyMarylandKansasOklahomaNew JerseyArkansasMassachusettsMississippiWashingtonArizonaWest VirginiaAlabamaMaineSouth CarolinaMontanaNorth DakotaOregonIdahoNew MexicoConnecticutUtahNew HampshireNevadaHawaiiWyomingVermontDelawareRhode IslandAlaskaWashington DC

About these prices

Based on prices published by 2256 US hospitals across 52 states, the typical (median) cash price is $212, versus a chargemaster (list) price around $355, a median insurer-negotiated rate of $157, a Medicare rate of about $101. Most cash prices fall between $95 and $510 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Occupational therapy evaluation (low complexity) cost without insurance?
The median cash (self-pay) price across 2256 US hospitals is $212. Most hospitals fall between $95 and $510. Prices vary widely between hospitals, so it pays to compare before you book.
What does Medicare pay for Occupational therapy evaluation (low complexity)?
Medicare pays about $101. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Occupational therapy evaluation (low complexity) prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

Related Therapy & Rehab

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See more Therapy & Rehab.