| Obstetric ultrasound limited CPT 76815 • Maternity | $41 | $93 | $144 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $50 | $92 | $126 |
| Interactive complexity add-on CPT 90785 • Mental Health | $19 | $27 | $34 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $131 | $265 | $389 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $146 | $309 | $503 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $64 | $110 | $171 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $75 | $127 | $178 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $74 | $148 | $257 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $104 | $161 | $226 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $110 | $205 | $378 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $138 | $216 | $299 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $140 | $231 | $322 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $114 | $180 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $96 | $164 | $246 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $142 | $203 | $256 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $54 | $69 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $10 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $83 | $179 | $328 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $240 | $261 | $299 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $202 | $239 | $278 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $558 | $820 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $517 | $779 | $974 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $109 | $226 | $285 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $150 | $236 | $408 |
| EMG needle each extremity complete CPT 95886 • Neurology | $116 | $169 | $247 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $133 | $202 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $201 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $155 | $198 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $240 | $358 | $446 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $375 | $558 | $728 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $90 | $100 | $127 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $121 | $141 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $126 | $217 | $291 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $129 | $290 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $32 | $55 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $59 | $80 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $64 | $100 | $124 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $134 | $190 | $251 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $135 | $190 | $256 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $101 | $132 | $175 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $123 | $166 | $231 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $219 | $315 | $480 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $67 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $91 | $114 | $141 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $163 | $212 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $86 | $111 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $108 | $175 | $254 |
| Consultation office straightforward CPT 99241 • Office Visits | $58 | $58 | $58 |
| Consultation office low complexity CPT 99243 • Office Visits | $129 | $172 | $227 |
| Consultation office high complexity CPT 99245 • Office Visits | $278 | $412 | $525 |