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Individual Behavior Change Counseling, First 30 Min

North Carolina rates for HCPCS 96158

This is a one-on-one counseling session with a trained clinician, such as a psychologist, focused on helping someone change habits that affect an existing physical health condition, such as improving diet, exercise, or medication routines for a condition like diabetes or heart disease. It covers the first 30 minutes of the session. It is aimed at supporting treatment of a diagnosed physical illness rather than treating a mental health condition on its own.

Rates data updated July 2026.

How much does Individual Behavior Change Counseling, First 30 Min cost?

$67.61

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $67.61 for this service. The price depends on where it is billed: about $67.61 from a physician practice, and about $66.07 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$67.61$61.66 to $83.18
FacilityA hospital or hospital-owned outpatient department$66.07$58.88 to $79.43

How much rates vary

Facilitymedian $66 · 10th to 90th $56 to $105Professionalmedian $68 · 10th to 90th $54 to $145
$20.0$50.0$100.0$200.0$500.0facility $66professional $68

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
$58.88
Median
$87.10
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$64.57
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$93.33
BCBS
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$79.43
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$75.86
Typical High
$144.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$66.07
Typical High
$91.20
Medcost
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$56.23
Typical High
$56.23
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$60.26
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$48.98
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$66.07
Typical High
$123.03
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$562.34
Typical High
$562.34

Where North Carolina sits

The same service costs 1.5 times more in Minnesota than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $67.61 · 7th of 51
MN $89.13DE $58.88

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.