Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS
Macon, GA
See all hospitals reporting CPT 97165 →Price type
Central Georgia Rehabilitation LLC’s median price of $162 is 4% above the median hospital's median price ($155), higher than 53% of the 2,514 hospitals reporting CPT 97165. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 30 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Aetna medicare advantage fee schedule · both | $94.97 | $94.97 | $94.97 – $94.97 |
| 2 | Aetna medicare advantage fee schedule · outpatient | $94.97 | $94.97 | $94.97 – $94.97 |
| 3 | Anthem medicare advantage fee schedule · both | $94.97 | $94.97 | $94.97 – $94.97 |
| 4 | Anthem medicare advantage fee schedule · outpatient | $94.97 | $94.97 | $94.97 – $94.97 |
| 5 | Humana medicare advantage fee schedule · both | $94.97 | $94.97 | $94.97 – $94.97 |
| 6 | Humana medicare advantage fee schedule · outpatient | $94.97 | $94.97 | $94.97 – $94.97 |
| 7 | UnitedHealthcare medicare advantage fee schedule · both | $94.97 | $94.97 | $94.97 – $94.97 |
| 8 | UnitedHealthcare medicare advantage fee schedule · outpatient | $94.97 | $94.97 | $94.97 – $94.97 |
| 9 | Caresource medicare advantage fee schedule · both | $96.87 | $96.87 | $96.87 – $96.87 |
| 10 | Caresource medicare advantage fee schedule · outpatient | $96.87 | $96.87 | $96.87 – $96.87 |
| 11 | Clover medicare advantage fee schedule · both | $96.87 | $96.87 | $96.87 – $96.87 |
| 12 | Clover medicare advantage fee schedule · outpatient | $96.87 | $96.87 | $96.87 – $96.87 |
| 13 | Ambetter managed medicaid fee schedule · both | $128.21 | $128.21 | $128.21 – $128.21 |
| 14 | Ambetter managed medicaid percent of total billed charges · outpatientfrom % of charges | $139.20 | $139.20 | $139.20 – $139.20 |
| 15 | Anthem hmo/ppo percent of total billed charges · outpatientfrom % of charges | $221.05 | $221.05 | $221.05 – $221.05 |
| 16 | Ambetter managed medicaid percent of total billed charges · inpatientfrom % of charges | $236.64 | $236.64 | $236.64 – $236.64 |
| 17 | Cigna commercial case rate · outpatient | $266.00 | $266.00 | $266.00 – $266.00 |
| 18 | Humana hmo/pos percent of total billed charges · outpatientfrom % of charges | $273.30 | $273.30 | $273.30 – $273.30 |
| 19 | Aetna hmo percent of total billed charges · outpatientfrom % of charges | $273.76 | $273.76 | $273.76 – $273.76 |
| 20 | UnitedHealthcare commercial case rate · outpatient | $294.00 | $294.00 | $294.00 – $294.00 |
| 21 | Aetna pos percent of total billed charges · outpatientfrom % of charges | $301.60 | $301.60 | $301.60 – $301.60 |
| 22 | Kaiser commercial percent of total billed charges · outpatientfrom % of charges | $301.60 | $301.60 | $301.60 – $301.60 |
| 23 | MultiPlan pho agreement primary network percent of total billed charges · inpatientfrom % of charges | $301.60 | $301.60 | $301.60 – $301.60 |
| 24 | MultiPlan pho agreement primary network percent of total billed charges · outpatientfrom % of charges | $301.60 | $301.60 | $301.60 – $301.60 |
| 25 | Humana ppo percent of total billed charges · outpatientfrom % of charges | $318.77 | $318.77 | $318.77 – $318.77 |
Last updated: Nov 19, 2025
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