| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $50 | $66 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $24 | $52 | $87 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $10 | $22 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $93 | $144 | $253 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $124 | $167 | $286 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $70 | $85 | $115 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $70 | $79 | $95 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $67 | $93 | $134 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $78 | $97 | $134 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $105 | $152 | $224 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $90 | $111 | $160 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $153 | $216 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $61 | $97 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $68 | $92 | $145 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $78 | $105 | $151 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $36 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $207 | $207 | $207 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $140 | $169 | $198 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $110 | $157 | $205 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $241 | $473 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $67 | $82 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $68 | $78 | $87 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $65 | $131 | $228 |
| EMG needle each extremity complete CPT 95886 • Neurology | $72 | $79 | $86 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $85 | $129 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $66 | $92 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $65 | $84 | $118 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $155 | $203 | $251 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $256 | $261 | $267 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $68 | $78 | $101 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $115 | $158 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $165 | $238 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $209 | $260 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $25 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $52 | $86 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $82 | $107 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $6 | $99 | $155 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $184 | $198 | $213 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $118 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $167 | $193 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $173 | $243 | $279 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $58 | $73 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $87 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $150 | $175 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $64 | $85 | $119 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $90 | $133 | $168 |
| Consultation office straightforward CPT 99241 • Office Visits | $53 | $53 | $53 |
| Consultation office low complexity CPT 99243 • Office Visits | $124 | $138 | $164 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $257 | $308 |