| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $83 | $83 | $83 |
| Interactive complexity add-on CPT 90785 • Mental Health | $7 | $7 | $7 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $201 | $213 | $220 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $168 | $168 | $168 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $67 | $93 | $107 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $56 | $56 | $56 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $109 | $116 | $127 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $91 | $91 | $91 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $159 | $159 | $160 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $147 | $147 | $147 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $158 | $180 | $203 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $79 | $94 | $110 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $105 | $107 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $120 | $127 | $131 |
| Group psychotherapy CPT 90853 • Mental Health | $36 | $36 | $36 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $176 | $176 | $176 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $174 | $174 | $174 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $164 | $164 | $164 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $64 | $64 | $64 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $64 | $64 | $64 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $99 | $99 | $99 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $137 | $137 | $137 |
| EMG needle each extremity complete CPT 95886 • Neurology | $114 | $114 | $114 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $69 | $69 | $69 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $86 | $86 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $183 | $183 | $183 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $240 | $240 | $240 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $151 | $151 | $151 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $72 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $94 | $108 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $151 | $156 | $165 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $171 | $185 | $192 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $23 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $43 | $44 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $62 | $70 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $91 | $96 | $106 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $113 | $123 | $133 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $102 | $102 | $102 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $140 | $140 | $140 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $206 | $206 | $206 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $76 | $76 | $76 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $109 | $109 | $109 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $77 | $77 | $77 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $111 | $111 | $111 |
| Consultation office straightforward CPT 99241 • Office Visits | $46 | $46 | $46 |
| Consultation office low complexity CPT 99243 • Office Visits | $146 | $146 | $146 |
| Consultation office high complexity CPT 99245 • Office Visits | $220 | $220 | $220 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $687 | $687 | $687 |