| Blood typing Rh CPT 86901 • Laboratory | $1 | $3 | $5 |
| Urine culture bacterial colony count CPT 87086 • Laboratory | $4 | $7 | $12 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $17 | $32 | $53 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $17 | $32 | $53 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $51 | $60 | $77 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $10 | $16 | $25 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $81 | $89 | $102 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $173 | $214 | $275 |
| Chorionic villus sampling CPT 59015 • Maternity | $83 | $118 | $137 |
| Fetal non-stress test CPT 59025 • Maternity | $28 | $51 | $72 |
| Insertion cervical dilator CPT 59200 • Maternity | $67 | $76 | $93 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $1,900 | $2,644 | $3,658 |
| Vaginal delivery only CPT 59409 • Maternity | $697 | $995 | $1,485 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $622 | $1,040 | $1,575 |
| External cephalic version CPT 59412 • Maternity | $59 | $82 | $100 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $154 | $550 | $901 |
| Postpartum care only CPT 59430 • Maternity | $168 | $191 | $233 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $1,552 | $2,092 | $2,637 |
| Cesarean delivery only CPT 59514 • Maternity | $784 | $1,060 | $1,485 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,129 | $1,576 | $2,023 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $1,463 | $1,975 | $2,487 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $107 | $134 | $178 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $91 | $116 | $136 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $92 | $138 | $161 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $29 | $78 | $123 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $35 | $78 | $140 |
| Interactive complexity add-on CPT 90785 • Mental Health | $14 | $16 | $20 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $158 | $190 | $267 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $183 | $184 | $186 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $74 | $86 | $115 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $75 | $84 | $92 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $78 | $102 | $132 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $96 | $106 | $117 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $137 | $165 | $225 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $141 | $155 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $143 | $173 | $232 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $55 | $78 | $110 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $95 | $107 | $126 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $99 | $115 | $131 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $30 | $42 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $40 | $75 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $76 | $108 | $126 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $106 | $113 | $123 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $340 | $428 | $545 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $414 | $511 | $653 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $70 | $104 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $72 | $100 | $149 |
| EMG needle each extremity complete CPT 95886 • Neurology | $87 | $108 | $149 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $35 | $52 | $83 |