| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 70 | $60 | $4K |
| J1000 | Injection, depo-estradiol cypionate, up to 5 mg | 140 | $20 | $3K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 20 | $120 | $2.4K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 20 | $90 | $2.2K |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 140 | $20 | $2.1K |
| 76830 | The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient. | 10 | $90 | $1.1K |
| 76856 | A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal… | 20 | $70 | $1K |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 50 | $20 | $880 |
| G0444 | Annual depression screening, 5 to 15 minutes | 40 | $20 | $730 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 20 | $40 | $630 |