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Assessment Of Behavioral Factors In A Medical Condition

South Carolina 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 South Carolina, July 2026.

Insurers have agreed to pay about $95.50 for this service. Most negotiated rates run $85.11 to $105.

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 $100 · 10th to 90th $79 to $138Professionalmedian $95 · 10th to 90th $78 to $120
$20.0$50.0$100.0$200.0$500.0facility $100professional $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
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$100.00
Typical High
$165.96
Medcost
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$100.00
Typical High
$138.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$151.36

Where South Carolina 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.

South Carolina $95.50 · 20th 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.