| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $195 | $207 | $219 |
| Chorionic villus sampling CPT 59015 • Maternity | $166 | $166 | $166 |
| Fetal non-stress test CPT 59025 • Maternity | $16 | $36 | $46 |
| Insertion cervical dilator CPT 59200 • Maternity | $48 | $48 | $48 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $1,858 | $2,098 | $2,338 |
| Vaginal delivery only CPT 59409 • Maternity | $826 | $826 | $826 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $954 | $1,008 | $1,036 |
| External cephalic version CPT 59412 • Maternity | $111 | $111 | $111 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $633 | $633 | $633 |
| Postpartum care only CPT 59430 • Maternity | $149 | $149 | $149 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,103 | $2,341 | $2,578 |
| Cesarean delivery only CPT 59514 • Maternity | $976 | $976 | $976 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,149 | $1,149 | $1,149 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $488 | $1,628 | $2,441 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $86 | $86 | $86 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $50 | $50 | $50 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $96 | $96 | $96 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $65 | $93 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $38 | $60 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $141 | $171 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $145 | $180 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $59 | $81 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $49 | $84 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $89 | $116 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $94 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $138 | $155 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $131 | $140 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $176 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $81 | $88 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $91 | $118 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $107 | $136 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $55 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $82 | $82 | $82 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $150 | $168 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $146 | $146 | $146 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $218 | $292 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $164 | $164 | $164 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $36 | $74 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $77 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $56 | $56 | $56 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $48 | $48 | $48 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $67 | $77 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $163 | $163 | $163 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $124 | $124 | $124 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $220 | $220 | $220 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $65 | $68 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $69 | $96 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $115 | $163 |