| Obstetric ultrasound limited CPT 76815 • Maternity | $40 | $66 | $91 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $64 | $73 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $13 | $15 | $19 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $105 | $152 | $189 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $180 | $202 | $245 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $70 | $80 | $99 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $64 | $73 | $91 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $69 | $105 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $55 | $81 | $103 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $138 | $154 | $170 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $97 | $119 | $152 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $130 | $158 | $186 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $55 | $68 | $91 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $89 | $113 | $127 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $106 | $131 |
| Group psychotherapy CPT 90853 • Mental Health | $31 | $44 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $77 | $115 | $153 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $158 | $163 | $168 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $132 | $149 | $158 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $70 | $276 | $380 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $70 | $255 | $440 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $62 | $95 | $113 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $98 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $55 | $77 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $58 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $75 | $113 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $97 | $117 | $136 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $86 | $118 | $178 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $228 | $270 | $291 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $69 | $89 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $92 | $97 | $101 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $24 | $95 | $165 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $22 | $147 | $273 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $19 | $29 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $54 | $70 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $74 | $87 | $112 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $12 | $92 | $159 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $148 | $186 | $224 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $69 | $80 | $102 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $109 | $135 | $161 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $22 | $127 | $214 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $41 | $51 | $61 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $66 | $77 | $98 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $99 | $116 | $147 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $78 | $100 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $81 | $106 | $141 |
| Consultation office straightforward CPT 99241 • Office Visits | $65 | $65 | $65 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $122 | $140 |
| Consultation office high complexity CPT 99245 • Office Visits | $224 | $236 | $255 |