| Obstetric ultrasound limited CPT 76815 • Maternity | $31 | $54 | $77 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $22 | $89 | $132 |
| Interactive complexity add-on CPT 90785 • Mental Health | $16 | $18 | $20 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $110 | $143 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $160 | $176 | $211 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $58 | $75 | $95 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $72 | $87 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $76 | $89 | $111 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $110 | $116 | $121 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $111 | $144 | $180 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $151 | $165 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $153 | $200 | $248 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $72 | $93 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $86 | $103 | $121 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $111 | $130 | $148 |
| Group psychotherapy CPT 90853 • Mental Health | $33 | $44 | $55 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $213 | $221 | $229 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $183 | $214 | $244 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $171 | $177 | $183 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $78 | $191 | $305 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $341 | $429 | $517 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $93 | $93 | $93 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $109 | $126 | $135 |
| EMG needle each extremity complete CPT 95886 • Neurology | $90 | $111 | $133 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $97 | $120 | $143 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $120 | $135 | $166 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $69 | $79 | $89 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $190 | $225 | $261 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $312 | $385 | $458 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $20 | $62 | $84 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $58 | $99 | $125 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $115 | $157 | $221 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $138 | $190 | $221 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $27 | $32 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $48 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $73 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $95 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $157 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $107 | $128 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $148 | $184 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $155 | $200 | $271 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $58 | $82 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $79 | $97 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $113 | $125 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $82 | $90 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $119 | $144 |
| Consultation office straightforward CPT 99241 • Office Visits | $31 | $31 | $31 |
| Consultation office low complexity CPT 99243 • Office Visits | $137 | $152 | $166 |
| Consultation office high complexity CPT 99245 • Office Visits | $258 | $270 | $276 |