| Obstetric ultrasound limited CPT 76815 • Maternity | $36 | $63 | $81 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $38 | $69 | $87 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $8 | $14 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $126 | $151 | $162 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $144 | $167 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $76 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $81 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $84 | $108 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $76 | $83 | $87 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $97 | $127 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $106 | $118 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $131 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $65 | $81 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $94 | $107 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $109 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $40 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $6 | $69 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $66 | $102 | $127 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $67 | $107 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $254 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $392 | $414 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $66 | $96 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $108 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $86 | $92 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $39 | $60 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $78 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $63 | $73 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $144 | $186 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $184 | $255 | $288 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $73 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $102 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $66 | $133 | $185 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $141 | $158 | $200 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $15 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $45 | $54 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $7 | $66 | $101 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $83 | $180 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $71 | $124 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $49 | $90 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $134 | $149 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $96 | $191 | $248 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $4 | $49 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $7 | $71 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $15 | $84 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $7 | $76 | $117 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $97 | $120 | $143 |
| Consultation office straightforward CPT 99241 • Office Visits | $23 | $23 | $23 |
| Consultation office low complexity CPT 99243 • Office Visits | $94 | $115 | $135 |
| Consultation office high complexity CPT 99245 • Office Visits | $217 | $240 | $285 |