| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $37 | $74 | $111 |
| Interactive complexity add-on CPT 90785 • Mental Health | $8 | $21 | $30 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $262 | $280 | $303 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $212 | $305 | $366 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $52 | $97 | $131 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $82 | $120 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $141 | $167 | $206 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $129 | $141 | $152 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $90 | $186 | $243 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $190 | $196 | $201 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $234 | $239 | $244 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $109 | $128 | $147 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $130 | $148 | $166 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $162 | $168 | $174 |
| Group psychotherapy CPT 90853 • Mental Health | $41 | $42 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $6 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $211 | $223 | $234 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $188 | $205 | $222 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $195 | $206 | $217 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $235 | $437 | $640 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $115 | $528 | $742 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $179 | $185 | $190 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $127 | $199 | $272 |
| EMG needle each extremity complete CPT 95886 • Neurology | $148 | $157 | $165 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $144 | $148 | $152 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $85 | $137 | $190 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $102 | $165 | $228 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $115 | $207 | $298 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $165 | $326 | $487 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $52 | $93 | $125 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $79 | $130 | $181 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $123 | $218 | $327 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $33 | $276 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $30 | $36 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $64 | $91 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $91 | $114 | $145 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $102 | $130 | $205 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $186 | $260 | $349 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $132 | $164 | $186 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $181 | $228 | $269 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $184 | $298 | $396 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $55 | $66 | $76 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $97 | $125 | $141 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $174 | $180 | $187 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $100 | $122 | $142 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $144 | $168 | $182 |
| Consultation office straightforward CPT 99241 • Office Visits | $51 | $51 | $51 |
| Consultation office low complexity CPT 99243 • Office Visits | $116 | $151 | $186 |
| Consultation office high complexity CPT 99245 • Office Visits | $338 | $359 | $381 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $884 | $939 | $994 |