| Vaginal delivery only CPT 59409 • Maternity | $915 | $962 | $1,010 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $1,162 | $1,186 | $1,210 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $910 | $952 | $994 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,150 | $2,350 | $2,549 |
| Cesarean delivery only CPT 59514 • Maternity | $1,033 | $1,113 | $1,193 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,150 | $2,255 | $2,360 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $57 | $117 | $178 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $40 | $112 | $184 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $146 | $227 | $308 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $26 | $73 | $120 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $51 | $91 | $132 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $141 | $151 | $162 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $120 | $150 | $181 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $47 | $47 | $47 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $62 | $77 | $93 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $103 | $120 | $136 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $67 | $67 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $215 | $215 | $215 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $126 | $142 | $158 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $78 | $172 | $267 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $58 | $249 | $440 |
| EMG needle each extremity complete CPT 95886 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $46 | $57 | $67 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $124 | $178 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $190 | $241 | $291 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $51 | $69 | $87 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $93 | $110 | $128 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $84 | $94 | $104 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $155 | $201 | $247 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $17 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $40 | $51 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $47 | $65 | $84 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $80 | $81 | $82 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $161 | $172 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $59 | $91 | $122 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $171 | $171 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $250 | $250 | $250 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $46 | $51 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $92 | $92 | $92 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $75 | $103 | $131 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $57 | $75 | $93 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $72 | $77 | $81 |
| Consultation office low complexity CPT 99243 • Office Visits | $97 | $110 | $123 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $53 | $56 | $60 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $43 | $53 | $63 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $52 | $72 | $93 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,931 | $1,931 | $1,931 |
| Lumbar spine fusion posterior approach CPT 22612 • Orthopedics | $1,802 | $1,899 | $1,997 |