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Assessment Of Behavioral Factors In A Medical Condition

Oregon 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?

$105

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $102 from a physician practice, and about $151 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$102$87.10 to $158
FacilityA hospital or hospital-owned outpatient department$151$105 to $200

How much rates vary

Facilitymedian $151 · 10th to 90th $87 to $200Professionalmedian $102 · 10th to 90th $78 to $234
$20$50$100$200facility $151professional $102

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
$204.17
Median
$208.93
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$95.50
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$138.04
Typical High
$245.47
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$181.97
Typical High
$251.19
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$104.71
Typical High
$165.96
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$269.15
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$199.53
Typical High
$199.53
Providence
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$104.71
Typical High
$173.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$144.54
Typical High
$245.47
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$128.82
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$141.25
Typical High
$239.88

Where Oregon 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.

Oregon· 3rd of 51

$105

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.