| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $31 | $32 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $103 | $123 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $12 | $19 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $191 | $202 | $214 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $191 | $193 | $195 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $70 | $87 | $104 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $64 | $86 | $108 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $109 | $120 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $96 | $112 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $164 | $164 | $164 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $144 | $180 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $171 | $171 | $171 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $96 | $100 | $104 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $137 | $144 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $138 | $144 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $42 | $42 | $42 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $10 | $10 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $245 | $245 | $245 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $118 | $206 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $158 | $161 | $163 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $380 | $380 | $381 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $92 | $92 | $92 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $108 | $110 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $162 | $217 | $271 |
| EMG needle each extremity complete CPT 95886 • Neurology | $142 | $142 | $142 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $91 | $108 | $125 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $48 | $73 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $107 | $121 | $136 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $178 | $216 | $253 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $291 | $296 | $301 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $79 | $95 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $167 | $220 | $272 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $164 | $179 | $210 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $216 | $334 | $522 |
| Office visit established patient minimal CPT 99211 • Office Visits | $27 | $29 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $69 | $113 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $103 | $187 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $143 | $274 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $226 | $297 | $368 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $139 | $258 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $215 | $282 | $349 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $261 | $431 | $516 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $51 | $90 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $110 | $186 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $143 | $265 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $72 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $130 | $150 | $169 |
| Consultation office straightforward CPT 99241 • Office Visits | $51 | $51 | $51 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $90 | $151 |
| Consultation office high complexity CPT 99245 • Office Visits | $255 | $302 | $349 |