| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $30 | $189 | $347 |
| Chorionic villus sampling CPT 59015 • Maternity | $30 | $149 | $255 |
| Fetal non-stress test CPT 59025 • Maternity | $14 | $50 | $98 |
| Insertion cervical dilator CPT 59200 • Maternity | $55 | $82 | $114 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $2,200 | $2,985 | $4,136 |
| Vaginal delivery only CPT 59409 • Maternity | $721 | $1,263 | $1,753 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $807 | $1,509 | $2,251 |
| External cephalic version CPT 59412 • Maternity | $97 | $165 | $224 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $50 | $954 | $1,749 |
| Postpartum care only CPT 59430 • Maternity | $118 | $260 | $430 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,200 | $3,102 | $4,136 |
| Cesarean delivery only CPT 59514 • Maternity | $851 | $1,464 | $1,988 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $964 | $1,421 | $1,752 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,250 | $3,267 | $4,784 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $58 | $124 | $238 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $60 | $87 | $115 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $115 | $271 | $349 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $39 | $84 | $127 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $44 | $123 | $186 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $6 | $8 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $133 | $221 | $286 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $137 | $175 | $197 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $56 | $83 | $101 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $47 | $86 | $144 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $84 | $130 | $186 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $77 | $95 | $110 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $126 | $199 | $279 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $123 | $148 | $177 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $176 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $95 | $95 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $117 | $135 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $140 | $152 | $167 |
| Group psychotherapy CPT 90853 • Mental Health | $47 | $58 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $89 | $156 | $270 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $168 | $239 | $278 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $122 | $202 | $278 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $144 | $369 | $699 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $163 | $406 | $830 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $79 | $148 | $234 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $92 | $185 | $336 |
| EMG needle each extremity complete CPT 95886 • Neurology | $54 | $106 | $189 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $89 | $115 | $149 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $101 | $132 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $95 | $179 | $285 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $168 | $250 | $375 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $180 | $373 | $597 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $92 | $150 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $74 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $105 | $155 |