| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $42 | $74 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $75 | $86 | $100 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $9 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $135 | $182 | $211 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $162 | $211 | $324 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $85 | $96 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $75 | $84 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $96 | $112 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $95 | $103 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $135 | $162 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $125 | $138 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $150 | $151 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $72 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $117 | $139 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $135 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $43 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $83 | $101 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $85 | $140 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $115 | $127 | $134 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $62 | $134 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $62 | $246 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $116 | $126 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $110 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $89 | $120 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $57 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $83 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $125 | $201 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $156 | $204 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $330 | $432 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $70 | $85 | $118 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $111 | $145 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $161 | $257 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $161 | $220 | $339 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $19 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $48 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $72 | $92 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $14 | $109 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $118 | $190 | $303 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $108 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $145 | $171 | $199 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $29 | $148 | $214 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $82 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $76 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $135 | $170 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $89 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $129 | $175 |
| Consultation office straightforward CPT 99241 • Office Visits | $52 | $52 | $52 |
| Consultation office low complexity CPT 99243 • Office Visits | $12 | $70 | $129 |
| Consultation office high complexity CPT 99245 • Office Visits | $184 | $225 | $254 |