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Assessment Of Behavioral Factors In A Medical Condition

New Jersey 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 New Jersey, 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 $105 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 $102
FacilityA hospital or hospital-owned outpatient department$105$93.33 to $200

How much rates vary

Facilitymedian $105 · 10th to 90th $87 to $209Professionalmedian $91 · 10th to 90th $76 to $120
$100$200facility $105professional $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
$87.10
Median
$104.71
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$112.20
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$104.71
Typical High
$112.20
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$147.91
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$100.00
Typical High
$204.17
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$162.18
Typical High
$208.93
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$288.40
Typical High
$407.38
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$91.20
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$100.00
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$181.97

Where New Jersey 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.

New Jersey· 47th 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.