| Amniocentesis diagnostic CPT 59000 • Maternity | $96 | $96 | $96 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $195 | $220 | $245 |
| Chorionic villus sampling CPT 59015 • Maternity | $180 | $180 | $180 |
| Fetal non-stress test CPT 59025 • Maternity | $18 | $37 | $47 |
| Insertion cervical dilator CPT 59200 • Maternity | $92 | $92 | $92 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $30 | $940 | $1,850 |
| Vaginal delivery only CPT 59409 • Maternity | $929 | $929 | $929 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $1,036 | $1,037 | $1,038 |
| External cephalic version CPT 59412 • Maternity | $123 | $123 | $123 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $568 | $568 | $568 |
| Postpartum care only CPT 59430 • Maternity | $151 | $151 | $151 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,097 | $2,097 | $2,097 |
| Cesarean delivery only CPT 59514 • Maternity | $1,096 | $1,096 | $1,096 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,237 | $1,237 | $1,237 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $1,954 | $2,279 | $2,441 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $55 | $55 | $55 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $84 | $84 | $84 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $109 | $109 | $109 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $65 | $94 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $32 | $58 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $140 | $171 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $145 | $179 | $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 | $96 | $112 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $104 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $133 | $152 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $130 | $139 | $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 | $103 | $122 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $123 | $141 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $34 | $59 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $180 | $180 | $180 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $164 | $197 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $146 | $146 | $146 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $192 | $192 | $192 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $100 | $100 | $100 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $39 | $75 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $117 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $102 | $102 | $102 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $110 | $110 | $110 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $40 | $58 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $109 | $162 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $219 | $219 | $219 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $50 | $63 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $98 | $109 |