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
OT-EVALUATION LOW COMPLEXITY
Santa Ana, CA
See all hospitals reporting CPT 97165 →Price type
Orange County Global Medical Center’s median price of $170 is 10% above the median hospital's median price ($155), higher than 56% 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, 29 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 | Tricare champus tricare prime/extra standard facility · fee schedule · outpatient | $105.89 | $105.89 | $105.89 – $105.89 |
| 2 | Aetna aetna sr facility · percent of total billed charges · outpatientfrom % of charges | $111.46 | $111.46 | $111.46 – $111.46 |
| 3 | Blue Cross Blue Shield blue shield 65 sr hmo facility · percent of total billed charges · outpatientfrom % of charges | $111.46 | $111.46 | $111.46 – $111.46 |
| 4 | Humana humana medicare advantage hmo/pos facility · fee schedule · outpatient | $111.46 | $111.46 | $111.46 – $111.46 |
| 5 | Kaiser kaiser senior hmo facility · fee schedule · outpatient | $111.46 | $111.46 | $111.46 – $111.46 |
| 6 | UnitedHealthcare united healthcare sr facility · fee schedule · outpatient | $111.46 | $111.46 | $111.46 – $111.46 |
| 7 | MultiPlan multiplan wc facility · other · outpatient | $121.90 | $121.90 | $121.90 – $121.90 |
| 8 | UnitedHealthcare monarch health plan/united healthcare facility · per diem · outpatient | $168.00 | $168.00 | $168.00 – $168.00 |
| 9 | Aetna aetna all commercial payers facility · fee schedule · outpatient | $183.86 | $183.86 | $183.86 – $183.86 |
| 10 | UnitedHealthcare united healthcare hmo facility · per diem · outpatient | $211.00 | $211.00 | $211.00 – $211.00 |
| 11 | UnitedHealthcare united healthcare all payers facility · per diem · outpatient | $217.00 | $217.00 | $217.00 – $217.00 |
| 12 | Cigna cigna hmo facility · per diem · outpatient | $315.00 | $315.00 | $315.00 – $315.00 |
| 13 | Cigna cigna ppo facility · per diem · outpatient | $315.00 | $315.00 | $315.00 – $315.00 |
| 14 | Bcbs Ca blue shield ppo facility · fee schedule · outpatient | $424.66 | $424.66 | $424.66 – $424.66 |
| 15 | Blue Cross Blue Shield blue shield hmo facility · fee schedule · outpatient | $424.66 | $424.66 | $424.66 – $424.66 |
| 16 | Magellan magellan behavioral health comm facility · percent of total billed charges · inpatientfrom % of charges | $574.20 | $574.20 | $574.20 – $574.20 |
| 17 | Magellan magellan behavioral health comm facility · percent of total billed charges · outpatientfrom % of charges | $574.20 | $574.20 | $574.20 – $574.20 |
| 18 | Magellan magellan behavioral health sr facility · percent of total billed charges · inpatientfrom % of charges | $574.20 | $574.20 | $574.20 – $574.20 |
| 19 | Magellan magellan behavioral health sr facility · percent of total billed charges · outpatientfrom % of charges | $574.20 | $574.20 | $574.20 – $574.20 |
| 20 | Kaiser kaiser commercial hmo facility · percent of total billed charges · inpatientfrom % of charges | $589.32 | $589.32 | $589.32 – $589.32 |
| 21 | Kaiser kaiser commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $589.32 | $589.32 | $589.32 – $589.32 |
| 22 | Cigna cigna/outside payors facility · percent of total billed charges · inpatientfrom % of charges | $622.05 | $622.05 | $622.05 – $622.05 |
| 23 | Cigna cigna/outside payors facility · percent of total billed charges · outpatientfrom % of charges | $622.05 | $622.05 | $622.05 – $622.05 |
| 24 | MultiPlan multiplan ppo facility · percent of total billed charges · inpatientfrom % of charges | $669.90 | $669.90 | $669.90 – $669.90 |
| 25 | MultiPlan multiplan ppo facility · percent of total billed charges · outpatientfrom % of charges | $669.90 | $669.90 | $669.90 – $669.90 |
Last updated: Jun 15, 2026
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