Assessment of health behavior
Medicare pricing data for 1,336 providers across 42 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Assessment of health behavior (HCPCS code 96156) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $86.03, but hospitals typically charge $261.02 — a 3.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $86.03, your out-of-pocket cost would be approximately $17.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $66.00 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Jersey | $99 | $214 | 26 | 690 | +14.8% |
| Delaware | $95 | $251 | 11 | 659 | +10.9% |
| California | $93 | $282 | 153 | 2,372 | +7.6% |
| District of Columbia | $91 | $233 | 2 | 19 | +6.0% |
| Washington | $91 | $208 | 37 | 215 | +5.6% |
| Texas | $91 | $266 | 54 | 1,145 | +5.4% |
| Maryland | $88 | $269 | 39 | 338 | +2.6% |
| Colorado | $88 | $288 | 53 | 517 | +2.5% |
| Massachusetts | $88 | $345 | 7 | 157 | +2.2% |
| New York | $88 | $193 | 25 | 997 | +1.8% |
| Missouri | $87 | $290 | 27 | 241 | +1.7% |
| Minnesota | $87 | $360 | 43 | 388 | +1.3% |
| Illinois | $87 | $264 | 50 | 521 | +0.8% |
| North Carolina | $86 | $283 | 31 | 265 | +0.3% |
| Florida | $86 | $297 | 108 | 1,842 | -0.3% |
| Georgia | $85 | $213 | 30 | 262 | -0.8% |
| Pennsylvania | $85 | $263 | 57 | 788 | -1.6% |
| New Hampshire | $84 | $127 | 4 | 26 | -1.9% |
| Oregon | $84 | $270 | 97 | 433 | -1.9% |
| West Virginia | $84 | $207 | 18 | 274 | -2.5% |
| North Dakota | $84 | $103 | 3 | 16 | -2.5% |
| Wisconsin | $83 | $527 | 78 | 1,018 | -3.0% |
| Connecticut | $83 | $223 | 5 | 103 | -3.4% |
| Kansas | $82 | $203 | 16 | 225 | -4.8% |
| Indiana | $82 | $199 | 26 | 789 | -4.9% |
| South Carolina | $82 | $390 | 2 | 27 | -4.9% |
| Virginia | $81 | $247 | 16 | 154 | -5.5% |
| Alabama | $81 | $209 | 5 | 160 | -5.6% |
| Montana | $81 | $214 | 2 | 54 | -5.9% |
| Arkansas | $80 | $200 | 1 | 15 | -6.6% |
| Iowa | $80 | $331 | 5 | 14 | -7.0% |
| Ohio | $80 | $176 | 62 | 885 | -7.0% |
| Maine | $80 | $168 | 7 | 62 | -7.5% |
| Louisiana | $80 | $125 | 13 | 123 | -7.6% |
| Nevada | $79 | $109 | 3 | 949 | -7.6% |
| Tennessee | $78 | $246 | 32 | 376 | -9.2% |
| Arizona | $78 | $279 | 50 | 490 | -9.6% |
| Kentucky | $76 | $264 | 14 | 89 | -11.2% |
| Michigan | $76 | $225 | 28 | 148 | -11.8% |
| Oklahoma | $73 | $121 | 12 | 36 | -14.8% |
| Idaho | $70 | $176 | 8 | 59 | -18.6% |
| Utah | $69 | $273 | 48 | 326 | -20.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber