Assessment Of Behavioral Factors In A Medical Condition
Colorado rates for HCPCS 96156
A trained clinician evaluates the psychological, behavioral, or social factors that may be affecting how a person is coping with or managing a physical health condition, such as chronic pain, diabetes, or heart disease. This is used when the focus is a physical illness, not a separate mental health diagnosis.
Rates data updated October 2026.
How much does Assessment Of Behavioral Factors In A Medical Condition cost?
$97.72
Typical negotiated rate. In Colorado, October 2026.
Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $112 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 by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$97.72
$74.13 to $112
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$112
$97.72 to $138
How much rates vary
Facilitymedian $112 · 10th to 90th $98 to $174Professionalmedian $98 · 10th to 90th $71 to $112
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$112.20
Typical High
$173.78
Facility
None
$97.72
$112.20
$173.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$97.72
Typical High
$112.20
Professional
None
$95.50
$97.72
$112.20
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$95.50
Typical High
$134.90
Professional
None
$81.28
$95.50
$134.90
Cigna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$77.62
Typical High
$154.88
Professional
None
$69.18
$77.62
$154.88
Denver HMP
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$112.20
Typical High
$144.54
Facility
None
$97.72
$112.20
$144.54
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$125.89
Typical High
$194.98
Professional
None
$87.10
$125.89
$194.98
Select Health
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$177.83
Typical High
$229.09
Facility
None
$74.13
$177.83
$229.09
Select Health
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$97.72
Typical High
$141.25
Professional
None
$74.13
$97.72
$141.25
United
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$467.74
Typical High
$537.03
Facility
None
$446.68
$467.74
$537.03
United
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$74.13
Typical High
$97.72
Professional
None
$70.79
$74.13
$97.72
2 more rates 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
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Kaiser Permanente
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$66.07
Median
$83.18
Typical High
$109.65
Professional
HN · Bachelor's level
$66.07
$83.18
$109.65
Kaiser Permanente
Setting
Professional
Modifier
HO · Master's level
Typical Low
$66.07
Median
$87.10
Typical High
$109.65
Professional
HO · Master's level
$66.07
$87.10
$109.65
Where Colorado sits
The same service costs 3.0 times more in Alaska than in Oklahoma. 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.