| Cesarean delivery only CPT 59514 • Maternity | $933 | $988 | $1,043 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,429 | $1,429 | $1,429 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,470 | $2,470 | $2,470 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $64 | $101 | $139 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $104 | $134 | $163 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $91 | $94 | $97 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $37 | $39 | $42 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $43 | $46 | $49 |
| Interactive complexity add-on CPT 90785 • Mental Health | $8 | $12 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $101 | $123 | $144 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $156 | $188 | $220 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $60 | $65 | $70 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $71 | $71 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $69 | $81 | $93 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $76 | $83 | $90 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $117 | $128 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $106 | $119 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $145 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $58 | $70 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $96 | $113 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $96 | $116 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $25 | $29 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $65 | $120 | $176 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $150 | $150 | $150 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $134 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $303 | $303 | $303 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $72 | $244 | $416 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $176 | $176 | $176 |
| EMG needle each extremity complete CPT 95886 • Neurology | $96 | $107 | $118 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $100 | $100 | $100 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $51 | $51 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $62 | $62 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $195 | $195 | $195 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $119 | $119 | $119 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $48 | $71 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $95 | $103 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $157 | $168 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $204 | $247 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $21 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $45 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $47 | $65 | $75 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $70 | $94 | $106 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $141 | $184 | $234 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $83 | $92 | $101 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $137 | $153 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $201 | $213 | $225 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $51 | $64 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $72 | $87 | $103 |