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Assessment Of Behavioral Factors In A Medical Condition

Iowa 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 Iowa, 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 $120 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$87.10 to $120
FacilityA hospital or hospital-owned outpatient department$120$93.33 to $141

How much rates vary

Facilitymedian $120 · 10th to 90th $81 to $204Professionalmedian $95 · 10th to 90th $81 to $195
$20.0$50.0$100.0$200.0$500.0facility $120professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$95.50
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$177.83
Typical High
$331.13
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$107.15
Typical High
$263.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$204.17
Medica
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$154.88
Typical High
$588.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$218.78
Typical High
$257.04
Midlands
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$138.04
Typical High
$234.42
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$109.65
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$131.83
Typical High
$245.47
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$138.04
Typical High
$173.78

Where Iowa 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.

Iowa $95.50 · 35th 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.