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Assessment Of Behavioral Factors In A Medical Condition

South Dakota 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?

$97.72

Typical physician fee. In South Dakota, July 2026.

Insurers have agreed to pay about $97.72 for this service. Most negotiated rates run $85.11 to $120.

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.

How much rates vary

Facilitymedian $98 · 10th to 90th $81 to $151Professionalmedian $98 · 10th to 90th $72 to $186
$50.0$100.0$200.0$500.0facility $98professional $98

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
$89.13
Median
$100.00
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$93.33
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$190.55
Typical High
$239.88
Medica
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$162.18
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$125.89
Typical High
$616.60
Midlands
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$194.98
Typical High
$251.19
Midlands
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$199.53
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$204.17
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$194.98

Where South Dakota 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 Dakota $97.72 · 13th 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.