| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $50 | $71 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $54 | $71 | $89 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $8 | $14 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $89 | $137 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $95 | $157 | $194 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $37 | $68 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $31 | $67 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $62 | $107 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $51 | $83 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $90 | $101 | $111 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $83 | $102 | $115 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $136 | $140 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $68 | $78 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $122 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $81 | $110 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $23 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $144 | $165 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $83 | $135 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $93 | $125 | $147 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $232 | $327 | $383 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $259 | $355 | $451 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $38 | $93 | $128 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $114 | $159 |
| EMG needle each extremity complete CPT 95886 • Neurology | $32 | $66 | $100 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $34 | $75 | $101 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $92 | $111 | $131 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $110 | $126 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $64 | $149 | $206 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $142 | $249 | $321 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $63 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $55 | $80 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $107 | $131 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $111 | $151 | $188 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $25 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $39 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $38 | $54 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $73 | $110 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $69 | $107 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $68 | $100 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $102 | $119 | $135 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $29 | $126 | $199 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $34 | $38 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $51 | $71 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $70 | $102 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $52 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $78 | $97 | $109 |
| Consultation office straightforward CPT 99241 • Office Visits | $34 | $34 | $34 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $62 | $93 |
| Consultation office high complexity CPT 99245 • Office Visits | $168 | $205 | $238 |