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Assessment Of Behavioral Factors In A Medical Condition

Massachusetts 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?

$100

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 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 9 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$100$87.10 to $145
FacilityA hospital or hospital-owned outpatient department$95.50$87.10 to $120

How much rates vary

Facilitymedian $95 · 10th to 90th $63 to $138Professionalmedian $100 · 10th to 90th $78 to $240
$50$100$200$500facility $95professional $100

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
$87.10
Median
$87.10
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$177.83
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$309.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$131.83
Typical High
$162.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$134.90
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$257.04
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$95.50
Typical High
$128.82
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$120.23
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$144.54
Typical High
$263.03
Health New England
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Health New England
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$691.83
Typical High
$691.83
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$102.33
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$281.84

Where Massachusetts 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.

Massachusetts· 7th of 51

$100

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.