| Obstetric ultrasound limited CPT 76815 • Maternity | $50 | $72 | $84 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $36 | $62 | $93 |
| Interactive complexity add-on CPT 90785 • Mental Health | $11 | $13 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $106 | $120 | $127 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $153 | $162 | $167 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $52 | $62 | $70 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $57 | $64 | $69 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $61 | $81 | $93 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $62 | $77 | $88 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $90 | $107 | $134 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $93 | $106 | $115 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $117 | $125 | $132 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $43 | $51 | $61 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $65 | $84 | $98 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $78 | $86 | $102 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $22 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $95 | $119 | $136 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $120 | $126 | $131 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $19 | $75 | $131 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $176 | $310 | $360 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $359 | $377 | $410 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $89 | $117 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $73 | $100 | $141 |
| EMG needle each extremity complete CPT 95886 • Neurology | $85 | $88 | $94 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $16 | $50 | $80 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $92 | $118 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $61 | $108 | $141 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $80 | $132 | $158 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $91 | $153 | $259 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $64 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $84 | $92 | $104 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $13 | $100 | $159 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $145 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $19 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $45 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $50 | $61 | $72 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $7 | $70 | $105 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $126 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $62 | $74 | $99 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $15 | $92 | $133 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $13 | $123 | $196 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $6 | $31 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $57 | $70 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $89 | $97 | $110 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $31 | $54 | $71 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $9 | $75 | $104 |
| Consultation office straightforward CPT 99241 • Office Visits | $32 | $32 | $32 |
| Consultation office low complexity CPT 99243 • Office Visits | $8 | $69 | $120 |
| Consultation office high complexity CPT 99245 • Office Visits | $83 | $165 | $218 |