| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $51 | $70 | $76 |
| Interactive complexity add-on CPT 90785 • Mental Health | $14 | $15 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $124 | $174 | $224 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $167 | $208 | $239 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $75 | $78 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $69 | $81 | $96 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $88 | $107 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $87 | $87 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $142 | $154 | $166 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $162 | $164 | $165 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $153 | $153 | $153 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $66 | $66 | $66 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $103 | $107 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $110 | $110 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $35 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $149 | $205 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $167 | $219 | $271 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $176 | $226 | $277 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $63 | $218 | $512 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $75 | $251 | $598 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $57 | $57 | $57 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $168 | $168 | $168 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $95 | $131 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $107 | $107 | $107 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $94 | $95 | $97 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $162 | $179 | $197 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $213 | $236 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $412 | $429 | $445 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $73 | $98 | $128 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $107 | $145 | $185 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $140 | $186 | $219 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $208 | $245 | $289 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $17 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $42 | $60 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $60 | $68 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $82 | $107 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $116 | $182 | $233 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $90 | $121 | $139 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $140 | $169 | $189 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $186 | $240 | $273 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $51 | $57 | $68 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $84 | $91 | $97 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $127 | $146 | $179 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $90 | $94 | $100 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $127 | $134 | $144 |
| Consultation office straightforward CPT 99241 • Office Visits | $37 | $37 | $37 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $140 | $168 |
| Consultation office high complexity CPT 99245 • Office Visits | $248 | $293 | $338 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $647 | $647 | $647 |