| Obstetric ultrasound limited CPT 76815 • Maternity | $46 | $77 | $98 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $35 | $78 | $111 |
| Interactive complexity add-on CPT 90785 • Mental Health | $25 | $31 | $37 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $146 | $199 | $304 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $146 | $260 | $380 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $111 | $139 | $168 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $114 | $143 | $172 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $81 | $152 | $224 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $144 | $181 | $218 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $220 | $335 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $190 | $226 | $262 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $230 | $290 | $349 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $107 | $152 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $91 | $168 | $244 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $185 | $220 | $255 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $57 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $333 | $370 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $15 | $185 | $281 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $244 | $281 | $318 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $317 | $579 | $841 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $678 | $838 | $997 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $122 | $152 | $207 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $87 | $155 | $200 |
| EMG needle each extremity complete CPT 95886 • Neurology | $111 | $132 | $154 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $130 | $147 | $164 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $123 | $153 | $211 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $147 | $148 | $148 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $190 | $261 | $332 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $501 | $609 | $717 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $115 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $162 | $209 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $167 | $244 | $348 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $194 | $375 | $491 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $36 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $66 | $96 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $106 | $141 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $115 | $171 | $230 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $310 | $361 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $117 | $151 | $218 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $157 | $226 | $295 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $202 | $291 | $434 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $65 | $84 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $83 | $131 | $156 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $119 | $166 | $224 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $84 | $132 | $156 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $122 | $161 | $229 |
| Consultation office straightforward CPT 99241 • Office Visits | $54 | $54 | $54 |
| Consultation office low complexity CPT 99243 • Office Visits | $115 | $171 | $263 |
| Consultation office high complexity CPT 99245 • Office Visits | $211 | $397 | $499 |