| Obstetric ultrasound limited CPT 76815 • Maternity | $32 | $38 | $45 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $30 | $50 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $13 | $13 | $13 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $115 | $133 | $153 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $127 | $158 | $173 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $57 | $62 | $66 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $58 | $60 | $61 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $65 | $70 | $76 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $65 | $69 | $73 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $84 | $99 | $114 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $98 | $100 | $102 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $119 | $121 | $124 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $51 | $57 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $70 | $81 | $92 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $90 | $94 |
| Group psychotherapy CPT 90853 • Mental Health | $20 | $21 | $23 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $67 | $99 | $131 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $102 | $118 | $135 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $102 | $119 | $136 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $248 | $304 | $360 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $51 | $234 | $418 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $46 | $85 | $105 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $71 | $123 | $149 |
| EMG needle each extremity complete CPT 95886 • Neurology | $41 | $66 | $90 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $47 | $65 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $101 | $102 | $103 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $70 | $96 | $121 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $159 | $161 | $162 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $97 | $181 | $264 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $42 | $54 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $90 | $96 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $111 | $142 | $160 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $173 | $214 | $267 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $19 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $44 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $43 | $56 | $69 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $67 | $91 | $102 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $94 | $115 | $137 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $81 | $86 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $117 | $117 | $118 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $157 | $162 | $172 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $39 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $66 | $71 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $88 | $98 | $108 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $61 | $67 | $73 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $90 | $100 | $105 |
| Consultation office straightforward CPT 99241 • Office Visits | $41 | $41 | $41 |
| Consultation office low complexity CPT 99243 • Office Visits | $105 | $107 | $110 |
| Consultation office high complexity CPT 99245 • Office Visits | $190 | $200 | $204 |