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Assessment Of Behavioral Factors In A Medical Condition

Michigan 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 negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $95.50 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $112 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 8 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$95.50$85.11 to $112
FacilityA hospital or hospital-owned outpatient department$112$100 to $115

How much rates vary

Facilitymedian $112 · 10th to 90th $98 to $126Professionalmedian $95 · 10th to 90th $76 to $166
$10.0$20.0$50.0$100.0$200.0$500.0facility $112professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$95.50
Typical High
$165.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$112.20
BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$114.82
Typical High
$134.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$134.90
Typical High
$177.83
CareSource
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$64.57
Typical High
$109.65
CareSource
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$131.83
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$229.09
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$100.00
Typical High
$112.20
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$97.72
Typical High
$151.36
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$181.97
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$100.00
Typical High
$147.91

Where Michigan 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.

Michigan $95.50 · 30th 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.