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Assessment Of Behavioral Factors In A Medical Condition

Maine 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 physician fee. In Maine, July 2026.

Insurers have agreed to pay about $95.50 for this service. Most negotiated rates run $87.10 to $112.

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 $91 · 10th to 90th $91 to $102Professionalmedian $95 · 10th to 90th $78 to $162
$20.0$50.0$100.0$200.0facility $91professional $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. 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
$91.20
Median
$91.20
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$120.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$104.71
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$95.50
Typical High
$199.53
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$123.03
Typical High
$251.19
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$97.72
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$114.82
Typical High
$177.83

Where Maine 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.

Maine $95.50 · 32nd 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.