| Obstetric ultrasound limited CPT 76815 • Maternity | $27 | $40 | $63 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $37 | $71 | $117 |
| Interactive complexity add-on CPT 90785 • Mental Health | $14 | $16 | $18 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $110 | $141 | $175 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $160 | $190 | $209 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $51 | $73 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $63 | $76 | $95 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $69 | $88 | $111 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $88 | $104 | $120 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $136 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $116 | $130 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $141 | $157 | $173 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $72 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $95 | $115 | $135 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $119 | $139 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $31 | $37 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $186 | $186 | $186 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $113 | $135 | $157 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $179 | $179 | $179 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $483 | $483 | $483 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $77 | $77 | $77 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $116 | $138 | $160 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $111 | $148 | $166 |
| EMG needle each extremity complete CPT 95886 • Neurology | $68 | $68 | $68 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $72 | $72 | $72 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $90 | $103 | $115 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $57 | $125 | $193 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $110 | $110 | $110 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $151 | $151 | $151 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $86 | $100 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $112 | $127 | $142 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $116 | $143 | $172 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $154 | $202 | $274 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $19 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $34 | $45 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $76 | $88 | $99 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $89 | $110 | $144 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $148 | $157 | $165 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $106 | $135 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $148 | $183 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $122 | $184 | $268 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $47 | $52 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $79 | $96 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $93 | $116 | $138 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $86 | $97 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $109 | $142 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $94 | $111 | $129 |
| Consultation office high complexity CPT 99245 • Office Visits | $207 | $253 | $299 |