| Obstetric ultrasound limited CPT 76815 • Maternity | $31 | $74 | $144 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $56 | $116 | $227 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $20 | $33 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $131 | $152 | $183 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $122 | $242 | $350 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $61 | $101 | $152 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $40 | $100 | $158 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $72 | $112 | $148 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $66 | $103 | $145 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $116 | $179 | $304 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $165 | $263 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $148 | $163 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $70 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $160 | $245 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $170 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $35 | $51 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $74 | $180 | $368 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $44 | $177 | $257 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $97 | $202 | $294 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $455 | $827 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $53 | $359 | $950 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $165 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $76 | $147 | $235 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $125 | $212 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $57 | $110 | $227 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $212 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $102 | $170 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $278 | $460 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $109 | $423 | $698 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $112 | $174 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $100 | $153 | $252 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $44 | $162 | $280 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $181 | $278 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $41 | $64 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $61 | $101 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $48 | $105 | $171 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $99 | $167 | $251 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $207 | $339 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $95 | $154 | $239 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $128 | $207 | $324 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $188 | $287 | $480 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $77 | $146 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $114 | $171 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $97 | $163 | $247 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $114 | $171 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $185 | $254 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $44 | $90 | $152 |
| Consultation office high complexity CPT 99245 • Office Visits | $179 | $366 | $525 |