| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $98 | $123 | $145 |
| Interactive complexity add-on CPT 90785 • Mental Health | $8 | $16 | $24 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $211 | $235 | $281 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $224 | $274 | $324 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $112 | $126 | $139 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $74 | $109 | $131 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $145 | $159 | $184 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $121 | $144 | $166 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $174 | $194 | $213 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $195 | $195 | $195 |
| 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 | $134 | $153 | $173 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $170 | $170 | $170 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $45 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $112 | $112 | $112 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $218 | $225 | $231 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $201 | $210 | $219 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $327 | $548 | $678 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $84 | $90 | $96 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $54 | $54 | $54 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $57 | $57 | $57 |
| EMG needle each extremity complete CPT 95886 • Neurology | $153 | $159 | $166 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $92 | $92 | $92 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $204 | $204 | $204 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $105 | $188 | $236 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $290 | $306 | $321 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $472 | $501 | $529 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $68 | $104 | $125 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $104 | $142 | $181 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $168 | $195 | $219 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $275 | $347 | $394 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $26 | $38 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $58 | $81 | $93 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $94 | $126 | $150 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $105 | $147 | $209 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $181 | $186 | $192 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $133 | $148 | $176 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $187 | $192 | $197 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $31 | $190 | $275 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $57 | $68 | $80 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $101 | $111 | $119 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $145 | $169 | $192 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $103 | $118 | $131 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $148 | $159 | $169 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| 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 |