| Obstetric ultrasound limited CPT 76815 • Maternity | $54 | $88 | $113 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $51 | $191 | $379 |
| Interactive complexity add-on CPT 90785 • Mental Health | $7 | $15 | $24 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $131 | $281 | $446 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $180 | $336 | $505 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $71 | $89 | $139 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $39 | $86 | $131 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $77 | $123 | $184 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $93 | $120 | $166 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $115 | $165 | $215 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $133 | $157 | $196 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $136 | $192 | $248 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $111 | $151 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $92 | $127 | $173 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $97 | $125 | $170 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $45 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $296 | $583 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $181 | $198 | $218 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $280 | $461 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $75 | $528 | $1,318 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $639 | $1,550 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $66 | $82 | $104 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $57 | $133 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $68 | $138 | $215 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $77 | $148 | $219 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $75 | $184 | $285 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $139 | $186 | $223 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $116 | $277 | $443 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $110 | $317 | $472 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $96 | $126 | $182 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $163 | $263 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $166 | $214 | $279 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $208 | $306 | $419 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $31 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $67 | $105 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $117 | $178 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $107 | $178 | $224 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $181 | $242 | $354 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $110 | $158 | $250 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $187 | $238 | $339 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $209 | $381 | $501 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $64 | $97 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $101 | $132 | $179 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $119 | $163 | $257 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $127 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $144 | $205 | $265 |
| Consultation office straightforward CPT 99241 • Office Visits | $66 | $66 | $66 |
| Consultation office low complexity CPT 99243 • Office Visits | $131 | $144 | $165 |
| Consultation office high complexity CPT 99245 • Office Visits | $212 | $329 | $551 |