| Obstetric ultrasound limited CPT 76815 • Maternity | $44 | $64 | $85 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $87 | $107 | $128 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $18 | $36 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $157 | $262 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $195 | $279 | $363 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $128 | $162 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $44 | $82 | $99 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $86 | $166 | $216 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $71 | $104 | $153 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $144 | $243 | $324 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $115 | $192 | $248 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $298 | $317 | $336 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $143 | $151 | $162 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $105 | $199 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $225 | $269 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $58 | $71 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $165 | $259 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $271 | $354 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $157 | $217 | $277 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $465 | $851 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $113 | $145 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $296 | $296 | $296 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $203 | $203 | $203 |
| EMG needle each extremity complete CPT 95886 • Neurology | $131 | $178 | $224 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $54 | $54 | $54 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $94 | $190 | $287 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $197 | $199 | $200 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $108 | $184 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $412 | $444 | $476 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $85 | $102 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $104 | $120 | $151 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $165 | $258 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $20 | $207 | $334 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $22 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $62 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $100 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $91 | $144 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $111 | $145 | $191 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $78 | $108 | $137 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $173 | $236 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $216 | $273 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $53 | $65 | $78 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $99 | $121 | $143 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $183 | $194 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $125 | $134 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $144 | $177 | $211 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| Consultation office low complexity CPT 99243 • Office Visits | $85 | $127 | $168 |
| Consultation office high complexity CPT 99245 • Office Visits | $169 | $254 | $338 |