| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $98 | $123 | $145 |
| Interactive complexity add-on CPT 90785 • Mental Health | $8 | $8 | $8 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $214 | $254 | $281 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $224 | $273 | $324 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $112 | $112 | $112 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $75 | $90 | $105 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $145 | $146 | $147 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $121 | $121 | $121 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $176 | $195 | $213 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $196 | $196 | $196 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $292 | $292 | $292 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $151 | $151 | $151 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $136 | $136 | $136 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $170 | $170 | $170 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $48 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $235 | $235 | $235 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $218 | $225 | $231 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $201 | $201 | $201 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $327 | $502 | $678 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $96 | $171 | $246 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $131 | $131 | $131 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $122 | $122 | $122 |
| EMG needle each extremity complete CPT 95886 • Neurology | $68 | $117 | $166 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $165 | $165 | $165 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $204 | $204 | $204 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $236 | $240 | $244 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $136 | $136 | $136 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $199 | $350 | $501 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $97 | $111 | $125 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $143 | $162 | $181 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $219 | $264 | $296 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $269 | $305 | $372 |
| Office visit established patient minimal CPT 99211 • Office Visits | $31 | $31 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $58 | $71 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $94 | $127 | $159 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $105 | $165 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $192 | $202 | $212 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $133 | $135 | $136 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $187 | $192 | $197 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $249 | $263 | $275 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $57 | $68 | $80 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $101 | $110 | $119 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $145 | $163 | $181 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $103 | $117 | $131 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $148 | $159 | $169 |
| Consultation office straightforward CPT 99241 • Office Visits | $62 | $62 | $62 |
| Consultation office low complexity CPT 99243 • Office Visits | $192 | $192 | $192 |
| Consultation office high complexity CPT 99245 • Office Visits | $291 | $291 | $291 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $911 | $911 | $911 |