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Assessment Of Behavioral Factors In A Medical Condition

Kentucky 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 Kentucky, 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 $93.33 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$91.20$83.18 to $105
FacilityA hospital or hospital-owned outpatient department$93.33$72.44 to $120

How much rates vary

Facilitymedian $93 · 10th to 90th $65 to $151Professionalmedian $91 · 10th to 90th $69 to $138
$50$100$200$500facility $93professional $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
$95.50
Median
$138.04
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$162.18
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$91.20
Typical High
$97.72
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$70.79
Typical High
$93.33
CareSource
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$85.11
Typical High
$114.82
CareSource
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$102.33
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$120.23
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$61.66
Typical High
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$97.72
Typical High
$173.78

Where Kentucky sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Kentucky· 45th of 51

$91.20

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.