| Fetal non-stress test CPT 59025 • Maternity | $44 | $56 | $69 |
| Insertion cervical dilator CPT 59200 • Maternity | $49 | $70 | $91 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $2,000 | $2,701 | $3,403 |
| Vaginal delivery only CPT 59409 • Maternity | $723 | $1,204 | $1,684 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $953 | $955 | $957 |
| External cephalic version CPT 59412 • Maternity | $92 | $118 | $145 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $705 | $812 | $920 |
| Postpartum care only CPT 59430 • Maternity | $234 | $234 | $234 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,100 | $3,641 | $5,181 |
| Cesarean delivery only CPT 59514 • Maternity | $817 | $1,183 | $1,549 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,174 | $1,182 | $1,190 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,100 | $2,176 | $2,252 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $104 | $114 | $124 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $94 | $107 | $119 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $150 | $169 | $188 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $54 | $63 | $72 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $38 | $60 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $3 | $8 | $14 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $146 | $152 | $157 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $146 | $163 | $180 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $73 | $74 | $75 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $76 | $81 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $108 | $109 | $110 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $86 | $102 | $118 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $124 | $143 | $162 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $114 | $125 | $136 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $137 | $142 | $146 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $73 | $75 | $77 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $104 | $106 | $108 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $108 | $108 | $108 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $37 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $56 | $96 | $136 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $138 | $148 | $158 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $139 | $147 | $155 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $331 | $341 | $350 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $59 | $214 | $368 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $53 | $81 | $110 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $75 | $117 | $159 |
| EMG needle each extremity complete CPT 95886 • Neurology | $70 | $82 | $94 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $88 | $126 | $164 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $112 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $60 | $96 | $132 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $110 | $142 | $174 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $281 | $300 | $319 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $48 | $53 | $59 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $85 | $88 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $135 | $137 | $139 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $176 | $367 | $558 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $21 | $24 |