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Assessment Of Behavioral Factors In A Medical Condition

Florida 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?

$91.20

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $91.20 for this service. The price depends on where it is billed: about $91.20 from a physician practice, and about $77.62 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$91.20$83.18 to $105
FacilityA hospital or hospital-owned outpatient department$77.62$75.86 to $83.18

How much rates vary

Facilitymedian $78 · 10th to 90th $74 to $83Professionalmedian $91 · 10th to 90th $74 to $135
$1.0$5.0$20.0$100.0$500.0facility $78professional $91

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$77.62
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$125.89
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$151.36
AvMed
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$91.20
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$186.21
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$75.86
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$109.65
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$74.13
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$97.72
Typical High
$173.78
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$85.11
Typical High
$107.15

Where Florida 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.

Florida $91.20 · 43rd 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.