| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $23 | $25 | $28 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $5 | $17 | $28 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $5 | $28 | $51 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $12 | $13 | $13 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $112 | $137 | $162 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $194 | $225 | $255 |
| Chorionic villus sampling CPT 59015 • Maternity | $151 | $169 | $188 |
| Fetal non-stress test CPT 59025 • Maternity | $46 | $47 | $49 |
| Insertion cervical dilator CPT 59200 • Maternity | $95 | $99 | $103 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $1,927 | $2,132 | $2,338 |
| Vaginal delivery only CPT 59409 • Maternity | $783 | $875 | $967 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $1,035 | $1,058 | $1,081 |
| External cephalic version CPT 59412 • Maternity | $99 | $114 | $129 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $781 | $889 | $996 |
| Postpartum care only CPT 59430 • Maternity | $170 | $214 | $258 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,184 | $2,381 | $2,578 |
| Cesarean delivery only CPT 59514 • Maternity | $884 | $1,013 | $1,142 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,272 | $1,280 | $1,289 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,035 | $2,238 | $2,441 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $88 | $96 | $103 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $58 | $88 | $119 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $72 | $113 | $154 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $59 | $65 | $71 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $94 | $107 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $186 | $189 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $151 | $171 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $78 | $85 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $51 | $77 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $92 | $111 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $100 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $148 | $166 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $135 | $140 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $150 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $95 | $95 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $107 | $129 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $128 | $139 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $36 | $56 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $80 | $102 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $131 | $143 | $154 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $134 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $201 | $256 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $67 | $248 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $76 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $97 | $128 | $160 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $102 | $106 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $70 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $126 | $141 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $104 | $134 |