MaineHealth
MaineHealth in Portland, ME publishes cash prices for 50 common procedures listed here, from its own machine-readable price file updated Sep 9, 2025. Click a procedure to compare it with other hospitals nearby.
22 Bramhall St, Portland, ME 04102 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELVIS W/ CONTRAST | $2,826.25 | $2,826.25 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELVIS W/ CONTRAST | $2,826.25 | $2,826.25 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST | $1,017.05 | $1,017.05 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST | $1,017.05 | $1,017.05 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST | $1,741.05 | $1,741.05 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST | $1,741.05 | $1,741.05 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $838.25 | $838.25 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $838.25 | $838.25 | — |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $673.60 | $673.60 | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $673.60 | $673.60 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JOINT LOWER EXTREM W/O CONTRAST | $1,848.60 | $1,848.60 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JOINT LOWER EXTREM W/O CONTRAST | $1,848.60 | $1,848.60 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST | $2,999.20 | $2,999.20 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST | $2,999.20 | $2,999.20 | — |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O CONTRAST | $1,848.60 | $1,848.60 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O CONTRAST | $1,848.60 | $1,848.60 | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN STEM W/O & W/ CONTRAST | $2,999.20 | $2,999.20 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN STEM W/O & W/ CONTRAST | $2,999.20 | $2,999.20 | — |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $1,848.60 | $1,848.60 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $1,848.60 | $1,848.60 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $81.35 | $81.35 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME | $577.85 | $577.85 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $81.35 | $81.35 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME | $577.85 | $577.85 | — |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $673.60 | $673.60 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $673.60 | $673.60 | — |
| Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL | $83.10 | $83.10 | — |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB | $660.25 | $660.25 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL | $83.10 | $83.10 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB | $660.25 | $660.25 | — |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE REAL TIME | $873.80 | $873.80 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMINAL COMPLETE REAL TIME | $873.80 | $873.80 | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC XRAY EXAM L-2 SPINE 4/> VIEWS | $775.25 | $775.25 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XRAY EXAM L-2 SPINE 4/> VIEWS | $775.25 | $775.25 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 B* HC BASIC METABOLIC PANEL CALCIUM TOTAL | $371.65 | $371.65 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 B* HC BASIC METABOLIC PANEL CALCIUM TOTAL | $371.65 | $371.65 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 B* HC LIPID PANEL | $276.55 | $276.55 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 B* HC LIPID PANEL | $276.55 | $276.55 | — |
| Complete blood count (CBC) with differential CPT 85025 B* HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $143.70 | $143.70 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 B* HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $143.70 | $143.70 | — |
| Complete blood count (CBC), no differential CPT 85027 B* HC BLOOD COUNT COMPLETE AUTOMATED | $129.10 | $129.10 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 B* HC BLOOD COUNT COMPLETE AUTOMATED | $129.10 | $129.10 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 B* HC COMPREHENSIVE METABOLIC PANEL | $374.85 | $374.85 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 B* HC COMPREHENSIVE METABOLIC PANEL | $374.85 | $374.85 | — |
| Kidney function blood test panel CPT 80069 B* HC RENAL FUNCTION PANEL | $342.75 | $342.75 | — |
| Kidney function blood test panel inpatient CPT 80069 B* HC RENAL FUNCTION PANEL | $342.75 | $342.75 | — |
| Liver function blood test panel CPT 80076 B* HC HEPATIC FUNCTION PANEL | $260.40 | $260.40 | — |
| Liver function blood test panel inpatient CPT 80076 B* HC HEPATIC FUNCTION PANEL | $260.40 | $260.40 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 B* HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $177.00 | $177.00 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 B* HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $177.00 | $177.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 B* HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $273.70 | $273.70 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 B* PSA SCREENING | $274.35 | $274.35 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 B* HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $273.70 | $273.70 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 B* PSA SCREENING | $274.35 | $274.35 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 B* HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $112.00 | $112.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 B* HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $112.00 | $112.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 B* HC PROTHROMBIN TIME | $87.45 | $87.45 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $87.45 | $87.45 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 B* HC PROTHROMBIN TIME | $87.45 | $87.45 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $87.45 | $87.45 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 B* HC ASSAY OF THYROID STIMULATING HORMONE TSH | $300.70 | $300.70 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 B* HC ASSAY OF THYROID STIMULATING HORMONE TSH | $300.70 | $300.70 | — |
| Urinalysis with microscope exam, automated CPT 81001 B* HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $35.55 | $35.55 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 B* HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $35.55 | $35.55 | — |
| Urinalysis with microscope exam, manual CPT 81000 B* HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $27.50 | $27.50 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 B* HC URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $27.50 | $27.50 | — |
| Urinalysis without microscope exam, automated CPT 81003 B* HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $23.75 | $23.75 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 B* HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $23.75 | $23.75 | — |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIP STICK | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual CPT 81002 B* HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS W/O MICRO | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS W/O MICRO | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIP STICK | $27.85 | $27.85 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 B* HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $27.85 | $27.85 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY - CATH LAB RATE | $7,942.00 | $7,942.00 | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY - CATH LAB RATE | $7,942.00 | $7,942.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $219.50 | $219.50 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ INTERLAMINAR LMBR/SAC W/ IMG GUIDE | $1,209.85 | $1,209.85 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $219.50 | $219.50 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ INTERLAMINAR LMBR/SAC W/ IMG GUIDE | $1,209.85 | $1,209.85 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $237.35 | $237.35 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ INTERLAMINAR LMBR/SAC W/O IMG GUIDE | $1,209.85 | $1,209.85 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $237.35 | $237.35 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ INTERLAMINAR LMBR/SAC W/O IMG GUIDE | $1,209.85 | $1,209.85 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $240.45 | $240.45 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC TRANSFORAM L/S SGL | $971.75 | $971.75 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $240.45 | $240.45 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC TRANSFORAM L/S SGL | $971.75 | $971.75 | — |
| Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE | $1,641.65 | $1,641.65 | — |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE | $1,641.65 | $1,641.65 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSY TX W/PT PRESENT 50 MIN | $180.95 | $180.95 | — |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PT PRESENT | $180.95 | $180.95 | — |
| Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $293.60 | $293.60 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSY TX W/PT PRESENT 50 MIN | $180.95 | $180.95 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PT PRESENT | $180.95 | $180.95 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $293.60 | $293.60 | — |
| Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $248.05 | $248.05 | — |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN | $410.25 | $410.25 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $248.05 | $248.05 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN | $410.25 | $410.25 | — |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $40.05 | $40.05 | — |
| Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY | $69.05 | $69.05 | — |
| Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY - AMBULATORY RATE | $69.05 | $69.05 | — |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $40.05 | $40.05 | — |
| Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY - AMBULATORY RATE | $69.05 | $69.05 | — |
| Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY | $69.05 | $69.05 | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES - AMBULATORY RATE | $137.25 | $137.25 | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $164.30 | $164.30 | — |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE/OUTPT NEW LEV 3 | $191.35 | $191.35 | — |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE/OUTPT NEW LEV 3 - AMBULATORY RATE | $200.95 | $200.95 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES - AMBULATORY RATE | $137.25 | $137.25 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $164.30 | $164.30 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE/OUTPT NEW LEV 3 | $191.35 | $191.35 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE/OUTPT NEW LEV 3 - AMBULATORY RATE | $200.95 | $200.95 | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES - AMBULATORY RATE | $235.90 | $235.90 | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $281.65 | $281.65 | — |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE/OUTPT NEW LEV 4 | $345.75 | $345.75 | — |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE/OUTPT NEW LEV 4 - AMBULATORY RATE | $363.50 | $363.50 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES - AMBULATORY RATE | $235.90 | $235.90 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $281.65 | $281.65 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE/OUTPT NEW LEV 4 | $345.75 | $345.75 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE/OUTPT NEW LEV 4 - AMBULATORY RATE | $363.50 | $363.50 | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES - AMBULATORY RATE | $302.60 | $302.60 | — |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE/OUTPT NEW LEV 5 | $434.70 | $434.70 | — |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE/OUTPT NEW LEV 5 - AMBULATORY RATE | $456.90 | $456.90 | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $468.40 | $468.40 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES - AMBULATORY RATE | $302.60 | $302.60 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE/OUTPT NEW LEV 5 | $434.70 | $434.70 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE/OUTPT NEW LEV 5 - AMBULATORY RATE | $456.90 | $456.90 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $468.40 | $468.40 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES 1/> AREAS EA 15 MIN | $152.15 | $152.15 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES 1/> AREAS EA 15 MIN | $152.15 | $152.15 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $242.60 | $242.60 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $242.60 | $242.60 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $294.55 | $294.55 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $294.55 | $294.55 | — |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY 16-37 MIN | $90.45 | $90.45 | — |
| Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $118.70 | $118.70 | — |
| Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES - AMBULATORY RATE | $150.65 | $150.65 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY 16-37 MIN | $90.45 | $90.45 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $118.70 | $118.70 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES - AMBULATORY RATE | $150.65 | $150.65 | — |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY 38-52 MIN | $161.05 | $161.05 | — |
| Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $183.00 | $183.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES - AMBULATORY RATE | $186.25 | $186.25 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY 38-52 MIN | $161.05 | $161.05 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $183.00 | $183.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES - AMBULATORY RATE | $186.25 | $186.25 | — |
| Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES - AMBULATORY RATE | $206.20 | $206.20 | — |
| Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $209.15 | $209.15 | — |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY 53+ MIN | $213.65 | $213.65 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES - AMBULATORY RATE | $206.20 | $206.20 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $209.15 | $209.15 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY 53+ MIN | $213.65 | $213.65 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE/OP CONSULT LEVEL III | $121.60 | $121.60 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $331.05 | $331.05 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES - AMBULATORY RATE | $414.00 | $414.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE/OP CONSULT LEVEL III | $121.60 | $121.60 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $331.05 | $331.05 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES - AMBULATORY RATE | $414.00 | $414.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE/OP CONSULT LEVEL IV | $179.55 | $179.55 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $527.65 | $527.65 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES - AMBULATORY RATE | $591.20 | $591.20 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE/OP CONSULT LEVEL IV | $179.55 | $179.55 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $527.65 | $527.65 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES - AMBULATORY RATE | $591.20 | $591.20 | — |