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Assessment Of Behavioral Factors In A Medical Condition

Delaware 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 July 2026.

How much does Assessment Of Behavioral Factors In A Medical Condition cost?

$87.10

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $77.62 to $97.72.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $204 · 10th to 90th $93 to $224Professionalmedian $87 · 10th to 90th $76 to $112
$20.0$50.0$100.0$200.0$500.0facility $204professional $87

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$112.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$141.25
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$177.83
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$87.10
Typical High
$147.91

Where Delaware sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Delaware $87.10 · 51st of 51
MN $129DE $87.10

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.