| Obstetric ultrasound limited CPT 76815 • Maternity | $46 | $75 | $91 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $34 | $35 | $38 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $11 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $146 | $159 | $165 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $147 | $157 | $172 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $61 | $67 | $75 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $64 | $71 | $85 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $79 | $90 | $110 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $88 | $97 | $102 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $113 | $119 | $128 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $121 | $138 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $154 | $165 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $70 | $77 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $77 | $101 | $130 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $98 | $113 | $130 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $32 | $35 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $71 | $107 | $143 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $41 | $115 | $162 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $56 | $83 | $110 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $303 | $309 | $314 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $339 | $348 | $357 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $43 | $47 | $51 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $75 | $94 | $130 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $65 | $84 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $48 | $69 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $60 | $86 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $64 | $99 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $101 | $138 | $176 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $171 | $229 | $288 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $44 | $47 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $52 | $78 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $56 | $107 | $153 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $199 | $228 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $18 | $27 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $19 | $30 | $40 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $71 | $75 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $74 | $110 | $167 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $10 | $76 | $142 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $9 | $52 | $95 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $12 | $70 | $128 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $173 | $181 | $188 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $3 | $21 | $39 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $31 | $49 | $68 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $9 | $55 | $102 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $74 | $80 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $100 | $102 | $105 |
| Consultation office straightforward CPT 99241 • Office Visits | $31 | $31 | $31 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $88 | $114 |
| Consultation office high complexity CPT 99245 • Office Visits | $179 | $195 | $211 |