| Vaginal delivery including postpartum care CPT 59410 • Maternity | $952 | $996 | $1,041 |
| External cephalic version CPT 59412 • Maternity | $94 | $94 | $94 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $942 | $942 | $942 |
| Postpartum care only CPT 59430 • Maternity | $243 | $243 | $243 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,200 | $2,200 | $2,200 |
| Cesarean delivery only CPT 59514 • Maternity | $1,490 | $1,490 | $1,490 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $30 | $594 | $1,158 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,350 | $2,350 | $2,350 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $104 | $104 | $104 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $120 | $120 | $120 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $154 | $154 | $154 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $30 | $30 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $89 | $89 | $89 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $9 | $13 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $105 | $148 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $173 | $177 | $182 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $66 | $79 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $61 | $82 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $129 | $129 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $67 | $91 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $137 | $137 | $137 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $102 | $105 | $108 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $124 | $124 | $124 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $71 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $150 | $150 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $118 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $58 | $58 | $58 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $131 | $131 | $131 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $135 | $136 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $360 | $363 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $418 | $418 | $418 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $104 | $108 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $159 | $160 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $86 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $106 | $109 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $134 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $162 | $169 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $264 | $275 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $66 | $68 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $103 | $103 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $164 | $164 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $212 | $212 | $212 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $26 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $52 | $53 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $50 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $69 | $108 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $137 | $137 | $137 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $53 | $76 |