Evaluation for Occupational Therapy, Typically 1 Hour Cost in Maine
What this costs without insurance: real self-pay cash prices and insurance-negotiated rates at 28 Maine hospitals. CPT 97167. Sourced directly from each facility's CMS-mandated transparency file. Dataset: Q4 2026.
📊 Median $246
📉 Low $30.00
📈 High $676
🏥 28 hospitals
🏛️ 28 with insurance contracts
🇺🇸 Medicare $98.24
Hospital comparison — Maine
Sorted by cash price (lowest first). Showing top 28 of 28 hospitals.
Billed more than $246 for this? That gap is evidence.
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| Hospital | Cash | Aetna | Cigna | UHC | Centene | Humana | MultiPlan | Medicare | TRICARE |
|---|---|---|---|---|---|---|---|---|---|
| NORTHERN MAINE MEDICAL CENTER FORT KENT |
$30.00 | $121 | $213 | $121 | $121 | $121 | $208 | — | $95.84 |
| NORTHERN LIGHT MAINE COAST HOSPITAL ELLSWORTH |
$77.75 | $95.84 | $222 | $95.84 | $95.84 | — | — | — | — |
| NORTHERN LIGHT A R GOULD HOSPITAL ACADEMY ST. PRESQUE ISLE |
$78.96 | $95.92 | $222 | $97.76 | $97.76 | — | — | — | — |
| EASTERN MAINE MEDICAL CENTER STATE ST BANGOR |
$86.73 | $95.92 | $222 | $97.76 | $97.76 | — | — | — | — |
| CENTRAL MAINE MEDICAL CENTER LEWISTON |
$96.00 | $96.53 | $95.00 | $96.53 | $96.53 | $96.53 | — | $96.53 | $96.53 |
| NORTHERN LIGHT MERCY HOSPITAL PORTLAND |
$138 | $95.92 | $222 | $103 | $103 | — | — | — | — |
| NORTHERN LIGHT MAYO HOSPITAL DOVER FOXCROFT |
$162 | $95.84 | $222 | $95.84 | $97.76 | — | — | — | — |
| SEBASTICOOK VALLEY HOSPITAL PITTSFIELD |
$167 | $95.84 | $222 | $97.76 | $97.76 | — | — | — | — |
| NORTHERN LIGHT ACADIA HOSPITAL BANGOR |
$175 | $95.84 | — | $97.76 | $97.76 | — | — | — | — |
| RUMFORD HOSPITAL RUMFORD |
$181 | — | $95.00 | — | — | — | — | — | — |
| NORTHERN LIGHT BLUE HILL MEMORIAL HOSPITAL WATER ST. BLUE HILL |
$182 | $95.84 | $222 | $97.76 | $97.76 | — | — | — | — |
| BRIDGTON HOSPITAL BRIDGTON |
$194 | — | $95.00 | — | — | — | — | — | — |
| HOULTON REGIONAL HOSPITAL HARTFORD STREET HOULTON |
$237 | $237 | — | — | — | — | — | — | — |
| NORTHERN LIGHT CA DEAN HOSPITAL PRITHAM AVE GREENVILLE |
$246 | $97.76 | $222 | $97.76 | $97.76 | — | — | — | — |
| MID COAST HOSPITAL BRUNSWICK |
$254 | $98.55 | $117 | $101 | $104 | $101 | $193 | — | — |
| SPRING HARBOR HOSPITAL WESTBROOK |
$308 | $101 | — | — | — | — | $176 | — | — |
| MILLINOCKET REGIONAL HOSPITAL MILLINOCKET |
$321 | $318 | $331 | — | $154 | $155 | — | $154 | — |
| PENOBSCOT VALLEY HOSPITAL LINCOLN |
$326 | $192 | $383 | $188 | $190 | $190 | — | $94.58 | — |
| REDINGTON-FAIRVIEW GENERAL HOSPITAL FAIRVIEW AVE SKOWHEGAN |
$328 | $438 | — | $438 | — | $438 | — | — | — |
| DOWN EAST COMMUNITY HOSPITAL MACHIAS |
$335 | $372 | $402 | $384 | $196 | $196 | — | — | — |
| CALAIS COMMUNITY HOSPITAL CALAIS |
$338 | $388 | $379 | $93.00 | $198 | $198 | — | — | — |
| WALDO COUNTY GENERAL HOSPITAL BELFAST |
$358 | $98.55 | $337 | $113 | $118 | $113 | $183 | — | — |
| PEN BAY MEDICAL CENTER ROCKPORT |
$397 | $98.55 | $201 | $101 | $104 | $101 | $193 | — | — |
| STEPHENS MEMORIAL HOSPITAL NORWAY |
$456 | $98.55 | $425 | $113 | $118 | $113 | $183 | — | — |
| MAINEHEALTH LINCOLN HOSPITAL DAMARISCOTTA |
$495 | $98.55 | $450 | $110 | $115 | $113 | $183 | — | — |
| MAINEHEALTH FRANKLIN HOSPITAL FARMINGTON |
$534 | $98.55 | $447 | $113 | $113 | — | $183 | — | — |
| MAINE MEDICAL CENTER PORTLAND |
$534 | $101 | $449 | $101 | $104 | $101 | $193 | — | — |
| MAINEHEALTH MAINE MEDICAL CENTER BIDDEFORD BIDDEFORD |
$676 | $101 | $568 | $101 | $104 | $101 | $193 | — | — |
What these prices are. Each figure is the facility’s own published self-pay (cash) price for CPT 97167, filed under the federal price transparency rule (45 CFR Part 180). Hospital facility charges may not include separate physician, anesthesia, or pathology fees. National median for this code: $277 across all reporting facilities. Dataset: Q4 2026. Always confirm the final price with the facility before booking.
Billed more than $246 for this?
That is the median of what the 28 Maine hospitals above publish for Evaluation for occupational therapy, typically 1 hour — their own figures, filed under federal law. A bill well above them is evidence you can put in writing.
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Medicare reimbursement benchmark
For CPT 97167 in Maine, Medicare reimburses about $98.24 on the 2026 Physician Fee Schedule (non-facility, state average across localities). Hospital cash prices for the same code in Maine range from $30.00 to $676 — that means hospital cash prices are typically 2.5x what Medicare pays. If a self-pay quote you receive is more than 2-3x the Medicare rate, ask the hospital for the cash-discount price in writing.
Frequently asked questions
- How much does evaluation for occupational therapy, typically 1 hour cost in Maine?
- Cash prices for evaluation for occupational therapy, typically 1 hour (CPT 97167) in Maine range from $30.00 to $676, with a median of $246. Prices vary widely by hospital.
- Where can I find the cheapest evaluation for occupational therapy, typically 1 hour in Maine?
- The cheapest Maine hospital published cash price for this procedure is $30.00. Use the table above sorted by cash price to find the lowest-priced facility near you.
- Are these the prices I'll pay?
- These are the rates hospitals publish. Final price depends on your insurance, deductible, and the specific services billed. Always confirm with the facility and your insurer before any procedure.
- Why do prices vary so much between hospitals?
- Hospitals set cash prices independently, and insurance contracts negotiate different rates per payer. Two facilities a few miles apart can charge 5-10x different prices for the same procedure.
- Where does this data come from?
- Federal law (45 CFR § 180) requires hospitals to publish their pricing in a machine-readable file. We aggregate these files and republish in a consumer-friendly format.
Evaluation for occupational therapy, typically 1 hour in nearby states
Other procedures in Maine
Methodology. Cash prices and insurance-negotiated rates published by each Maine facility under federal price transparency rules (45 CFR § 180). CPT code 97167 (Doctor Visits). Data refreshed regularly; verify with the facility before any procedure.