| Obstetric ultrasound limited CPT 76815 • Maternity | $21 | $46 | $59 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $24 | $53 | $84 |
| Interactive complexity add-on CPT 90785 • Mental Health | $11 | $17 | $20 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $140 | $176 | $198 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $118 | $180 | $220 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $51 | $78 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $57 | $83 | $100 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $91 | $102 | $124 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $76 | $96 | $122 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $137 | $171 | $193 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $89 | $137 | $167 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $107 | $166 | $201 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $58 | $70 | $93 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $110 | $125 | $155 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $133 | $161 |
| Group psychotherapy CPT 90853 • Mental Health | $39 | $44 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $136 | $256 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $73 | $132 | $191 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $102 | $159 | $190 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $55 | $320 | $474 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $46 | $224 | $541 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $19 | $120 | $177 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $67 | $151 | $250 |
| EMG needle each extremity complete CPT 95886 • Neurology | $35 | $81 | $125 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $33 | $81 | $130 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $53 | $132 | $182 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $81 | $113 | $135 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $31 | $154 | $253 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $117 | $246 | $420 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $4 | $94 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $31 | $141 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $130 | $196 | $270 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $246 | $360 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $29 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $10 | $68 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $41 | $122 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $98 | $155 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $128 | $233 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $12 | $116 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $45 | $176 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $16 | $275 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $57 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $105 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $83 | $175 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $6 | $92 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $110 | $168 | $238 |
| Consultation office straightforward CPT 99241 • Office Visits | $68 | $68 | $68 |
| Consultation office low complexity CPT 99243 • Office Visits | $43 | $109 | $177 |
| Consultation office high complexity CPT 99245 • Office Visits | $79 | $300 | $499 |