| Obstetric ultrasound limited CPT 76815 • Maternity | $41 | $64 | $91 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $51 | $79 | $132 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $6 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $137 | $155 | $187 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $152 | $171 | $181 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $78 | $78 | $78 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $52 | $52 | $52 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $69 | $85 | $101 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $85 | $85 | $85 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $125 | $148 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $136 | $136 | $136 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $204 | $204 | $204 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $105 | $105 | $105 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $85 | $93 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $118 | $118 | $118 |
| Group psychotherapy CPT 90853 • Mental Health | $34 | $34 | $34 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $164 | $189 | $215 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $161 | $161 | $161 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $140 | $149 | $158 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $59 | $163 | $267 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $59 | $249 | $440 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $38 | $38 | $38 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $85 | $85 | $85 |
| EMG needle each extremity complete CPT 95886 • Neurology | $95 | $100 | $106 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $115 | $115 | $115 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $61 | $65 | $67 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $81 | $129 | $170 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $95 | $150 | $178 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $286 | $315 | $369 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $68 | $84 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $72 | $113 | $140 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $172 | $270 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $113 | $199 | $328 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $23 | $29 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $48 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $66 | $78 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $73 | $136 | $207 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $179 | $230 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $98 | $122 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $130 | $155 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $192 | $229 | $338 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $46 | $51 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $71 | $79 | $92 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $101 | $150 | $217 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $83 | $93 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $81 | $98 | $110 |
| Consultation office straightforward CPT 99241 • Office Visits | $52 | $52 | $52 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $136 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $203 | $203 | $203 |