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Assessment Of Behavioral Factors In A Medical Condition

Maryland 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?

$93.33

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $93.33 for this service. Most negotiated rates run $83.18 to $107.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $138 · 10th to 90th $71 to $692Professionalmedian $93 · 10th to 90th $76 to $195
$10.0$20.0$50.0$100.0$200.0$500.0facility $138professional $93

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
$138.04
Median
$575.44
Typical High
$691.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$194.98
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$95.50
Typical High
$112.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$190.55
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$128.82
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$70.79
Typical High
$95.50
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$186.21
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$112.20
Typical High
$162.18

Where Maryland 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.

Maryland $93.33 · 41st 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.