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Assessment Of Behavioral Factors In A Medical Condition

Virginia 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 Virginia, 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 $100 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$95.50$85.11 to $105
FacilityA hospital or hospital-owned outpatient department$100$87.10 to $117

How much rates vary

Facilitymedian $100 · 10th to 90th $79 to $158Professionalmedian $95 · 10th to 90th $76 to $123
$20.0$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $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
Facility
Modifier
Global
Typical Low
$75.86
Median
$95.50
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$114.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$162.18
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$102.33
Typical High
$186.21
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$128.82
Medcost
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Medcost
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$97.72
Typical High
$144.54
Medcost
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Sentara
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$117.49
Typical High
$173.78
Sentara
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$123.03
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$100.00
Typical High
$181.97

Where Virginia 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.

Virginia $95.50 · 24th 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.