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Assessment Of Behavioral Factors In A Medical Condition

West 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 October 2026.

How much does Assessment Of Behavioral Factors In A Medical Condition cost?

$89.13

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $105 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$87.10$77.62 to $95.50
FacilityA hospital or hospital-owned outpatient department$105$95.50 to $105

How much rates vary

Facilitymedian $105 · 10th to 90th $95 to $295Professionalmedian $87 · 10th to 90th $71 to $132
$100$200$500$1Kfacility $105professional $87

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$104.71
Aetna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$95.50
Typical High
$95.50
CareSource
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$97.72
Typical High
$158.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$89.13
Typical High
$208.93
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$223.87
Median
$295.12
Typical High
$1,479.11
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$162.18
Typical High
$194.98
United
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$147.91

Where West Virginia sits

The same service costs 3.0 times more in Alaska than in Oklahoma. 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.

West Virginia· 35th of 51

$89.13

AK $204OK $67.61

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.