go back

Assessment Of Behavioral Factors In A Medical Condition

Georgia 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?

$95.50

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $95.50 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $85.11 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$95.50$85.11 to $107
FacilityA hospital or hospital-owned outpatient department$85.11$64.57 to $87.10

How much rates vary

Facilitymedian $85 · 10th to 90th $65 to $91Professionalmedian $95 · 10th to 90th $78 to $141
$1.0$10.0$100.0facility $85professional $95

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
$77.62
Median
$77.62
Typical High
$89.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$131.83
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$107.15
Typical High
$524.81
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$104.71
Typical High
$134.90
CareSource
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$85.11
Typical High
$91.20
CareSource
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$131.83
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$102.33
Typical High
$177.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$114.82
Typical High
$151.36
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$107.15
Typical High
$213.80

Where Georgia 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.

Georgia $95.50 · 25th 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.