| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $17 | $30 | $43 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $51 | $53 | $56 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $10 | $17 | $22 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $52 | $108 | $164 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $204 | $237 | $270 |
| Chorionic villus sampling CPT 59015 • Maternity | $200 | $204 | $207 |
| Fetal non-stress test CPT 59025 • Maternity | $21 | $22 | $24 |
| Insertion cervical dilator CPT 59200 • Maternity | $36 | $70 | $103 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $2,802 | $3,249 | $3,695 |
| Vaginal delivery only CPT 59409 • Maternity | $911 | $1,013 | $1,083 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $892 | $1,140 | $1,388 |
| External cephalic version CPT 59412 • Maternity | $137 | $169 | $202 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $661 | $876 | $1,091 |
| Postpartum care only CPT 59430 • Maternity | $219 | $239 | $259 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $3,104 | $3,319 | $3,533 |
| Cesarean delivery only CPT 59514 • Maternity | $1,185 | $1,232 | $1,290 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,362 | $1,524 | $1,686 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $1,627 | $2,283 | $2,939 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $95 | $107 | $119 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $47 | $83 | $118 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $109 | $113 | $116 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $66 | $67 | $67 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $77 | $85 | $94 |
| Interactive complexity add-on CPT 90785 • Mental Health | $17 | $19 | $20 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $182 | $193 | $203 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $195 | $209 | $229 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $81 | $85 | $89 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $75 | $84 | $92 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $119 | $120 | $122 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $107 | $112 | $117 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $178 | $179 | $180 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $140 | $154 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $178 | $182 | $186 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $86 | $87 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $115 | $129 | $143 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $135 | $149 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $31 | $33 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $96 | $146 | $196 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $121 | $150 | $178 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $147 | $157 | $168 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $286 | $401 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $73 | $75 | $77 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $82 | $86 | $91 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $104 | $111 | $118 |
| EMG needle each extremity complete CPT 95886 • Neurology | $63 | $80 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $53 | $55 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $74 | $93 | $113 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $57 | $73 | $88 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $113 | $145 | $177 |