| Obstetric ultrasound limited CPT 76815 • Maternity | $67 | $67 | $67 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $45 | $82 | $118 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $28 | $50 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $154 | $163 | $175 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $145 | $201 | $278 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $73 | $75 | $77 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $49 | $63 | $77 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $73 | $81 | $89 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $80 | $86 | $91 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $106 | $124 | $141 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $130 | $136 | $142 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $154 | $181 | $208 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $82 | $108 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $95 | $95 | $96 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $115 | $118 | $122 |
| Group psychotherapy CPT 90853 • Mental Health | $33 | $38 | $43 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $190 | $215 | $240 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $210 | $226 | $242 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $205 | $207 | $209 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $220 | $330 | $440 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $60 | $288 | $516 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $54 | $107 | $134 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $124 | $165 | $186 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $80 | $118 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $77 | $109 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $76 | $115 | $136 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $66 | $78 | $91 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $121 | $168 | $214 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $216 | $282 | $348 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $43 | $51 | $59 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $86 | $96 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $54 | $109 | $162 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $170 | $175 | $179 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $35 | $61 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $22 | $33 | $43 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $65 | $73 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $87 | $98 | $104 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $118 | $169 | $219 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $87 | $108 | $128 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $119 | $128 | $137 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $142 | $173 | $202 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $36 | $59 | $82 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $74 | $82 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $93 | $99 | $104 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $64 | $73 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $93 | $98 | $106 |
| Consultation office straightforward CPT 99241 • Office Visits | $49 | $49 | $49 |
| Consultation office low complexity CPT 99243 • Office Visits | $83 | $101 | $128 |
| Consultation office high complexity CPT 99245 • Office Visits | $182 | $207 | $224 |