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Assessment Of Behavioral Factors In A Medical Condition

Utah 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 Utah, 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 $162 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$95.50$87.10 to $115
FacilityA hospital or hospital-owned outpatient department$162$115 to $174

How much rates vary

Facilitymedian $162 · 10th to 90th $105 to $174Professionalmedian $95 · 10th to 90th $76 to $155
$20$50$100$200$500facility $162professional $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
$104.71
Median
$162.18
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$95.50
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$104.71
Typical High
$158.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$204.17
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$102.33
Typical High
$138.04
Select Health
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Select Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$147.91
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$131.83
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$95.50
Typical High
$147.91

Where Utah 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.

Utah· 19th of 51

$95.50

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.