| Obstetric ultrasound limited CPT 76815 • Maternity | $113 | $137 | $153 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $48 | $96 | $128 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $15 | $25 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $201 | $249 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $195 | $276 | $353 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $65 | $115 | $141 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $94 | $106 | $118 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $87 | $167 | $217 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $120 | $136 | $153 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $172 | $192 | $228 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $151 | $204 | $248 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $238 | $268 | $298 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $143 | $151 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $104 | $164 | $217 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $200 | $264 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $44 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $184 | $368 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $181 | $286 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $264 | $317 | $390 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $546 | $854 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $617 | $984 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $88 | $186 | $283 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $163 | $163 | $163 |
| EMG needle each extremity complete CPT 95886 • Neurology | $77 | $139 | $209 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $167 | $195 | $223 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $164 | $206 | $287 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $197 | $236 | $257 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $150 | $352 | $454 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $277 | $456 | $677 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $102 | $134 | $169 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $104 | $158 | $244 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $218 | $242 | $285 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $252 | $312 | $403 |
| Office visit established patient minimal CPT 99211 • Office Visits | $30 | $39 | $46 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $71 | $109 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $86 | $117 | $164 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $156 | $172 | $188 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $150 | $252 | $323 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $175 | $199 | $223 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $185 | $239 | $300 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $273 | $352 | $444 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $66 | $75 | $92 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $121 | $135 | $158 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $143 | $192 | $229 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $98 | $134 | $160 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $125 | $191 | $237 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| Consultation office low complexity CPT 99243 • Office Visits | $168 | $206 | $244 |
| Consultation office high complexity CPT 99245 • Office Visits | $308 | $375 | $493 |