| Obstetric ultrasound limited CPT 76815 • Maternity | $31 | $47 | $80 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $32 | $84 | $123 |
| Interactive complexity add-on CPT 90785 • Mental Health | $7 | $11 | $14 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $162 | $204 | $237 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $185 | $241 | $324 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $95 | $108 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $59 | $74 | $98 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $97 | $110 | $120 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $104 | $125 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $139 | $168 | $185 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $117 | $167 | $240 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $152 | $233 | $298 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $67 | $87 | $128 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $106 | $123 | $135 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $91 | $125 | $142 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $42 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $5 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $61 | $131 | $203 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $129 | $158 | $194 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $187 | $264 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $90 | $345 | $518 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $299 | $596 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $24 | $69 | $115 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $85 | $141 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $70 | $109 | $141 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $94 | $116 | $139 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $66 | $134 | $172 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $124 | $201 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $94 | $214 | $271 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $318 | $432 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $73 | $86 | $100 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $121 | $149 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $166 | $213 | $237 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $15 | $172 | $282 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $21 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $50 | $76 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $73 | $99 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $107 | $126 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $138 | $207 | $303 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $12 | $103 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $128 | $157 | $189 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $231 | $347 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $79 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $103 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $108 | $132 | $181 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $103 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $109 | $130 | $153 |
| Consultation office straightforward CPT 99241 • Office Visits | $35 | $35 | $35 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $107 | $165 |
| Consultation office high complexity CPT 99245 • Office Visits | $212 | $311 | $499 |