| Urine culture bacterial colony count CPT 87086 • Laboratory | $4 | $7 | $11 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $17 | $24 | $30 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $17 | $24 | $30 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $49 | $50 | $51 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $10 | $12 | $15 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $143 | $190 | $237 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $150 | $285 | $421 |
| Chorionic villus sampling CPT 59015 • Maternity | $98 | $207 | $316 |
| Fetal non-stress test CPT 59025 • Maternity | $34 | $47 | $59 |
| Insertion cervical dilator CPT 59200 • Maternity | $78 | $86 | $94 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $1,807 | $2,556 | $3,304 |
| Vaginal delivery only CPT 59409 • Maternity | $944 | $1,104 | $1,264 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $1,278 | $1,386 | $1,494 |
| External cephalic version CPT 59412 • Maternity | $121 | $148 | $174 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $1,181 | $1,295 | $1,409 |
| Postpartum care only CPT 59430 • Maternity | $133 | $175 | $216 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $3,190 | $3,361 | $3,532 |
| Cesarean delivery only CPT 59514 • Maternity | $1,569 | $1,587 | $1,605 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,000 | $1,448 | $1,896 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $3,008 | $3,277 | $3,547 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $132 | $170 | $208 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $105 | $119 | $133 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $105 | $149 | $192 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $86 | $115 | $143 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $93 | $101 | $109 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $12 | $17 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $131 | $167 | $203 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $164 | $182 | $200 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $59 | $70 | $81 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $60 | $73 | $85 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $85 | $96 | $107 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $97 | $107 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $131 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $113 | $120 | $127 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $120 | $149 | $178 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $67 | $76 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $115 | $120 | $126 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $94 | $107 | $121 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $29 | $31 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $47 | $136 | $226 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $141 | $181 | $221 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $130 | $154 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $103 | $252 | $400 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $94 | $315 | $536 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $97 | $115 | $132 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $94 | $120 | $146 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $86 | $113 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $61 | $80 | $100 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $76 | $101 | $126 |