go back

Assessment Of Behavioral Factors In A Medical Condition

Illinois 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?

$97.72

Typical negotiated rate. In Illinois, July 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 $95.50 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 7 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$97.72$87.10 to $129
FacilityA hospital or hospital-owned outpatient department$95.50$87.10 to $105

How much rates vary

Facilitymedian $95 · 10th to 90th $85 to $117Professionalmedian $98 · 10th to 90th $78 to $162
$10.0$20.0$50.0$100.0$200.0$500.0facility $95professional $98

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
$85.11
Median
$95.50
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$138.04
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$107.15
Typical High
$131.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$436.52
Typical High
$436.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$128.82
Typical High
$162.18
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
$102.33
Typical High
$177.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$112.20
Typical High
$309.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$151.36
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$104.71
Typical High
$173.78

Where Illinois 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.

Illinois $97.72 · 9th 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.