| Obstetric ultrasound limited CPT 76815 • Maternity | $39 | $51 | $62 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $26 | $33 | $44 |
| Interactive complexity add-on CPT 90785 • Mental Health | $12 | $15 | $19 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $96 | $152 | $180 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $121 | $145 | $180 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $48 | $62 | $75 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $55 | $63 | $77 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $71 | $95 | $107 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $97 | $119 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $106 | $110 | $112 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $91 | $110 | $137 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $111 | $147 | $178 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $48 | $68 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $84 | $87 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $80 | $97 | $121 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $39 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $2 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $6 | $27 | $48 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $22 | $57 | $103 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $26 | $65 | $103 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $145 | $234 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $45 | $229 | $413 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $40 | $54 | $67 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $64 | $134 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $39 | $71 | $104 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $19 | $30 | $42 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $93 | $105 | $117 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $87 | $112 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $63 | $84 | $105 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $146 | $147 | $148 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $4 | $31 | $58 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $85 | $87 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $125 | $138 | $151 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $147 | $157 | $167 |
| Office visit established patient minimal CPT 99211 • Office Visits | $2 | $4 | $7 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $35 | $41 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $39 | $46 | $54 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $82 | $118 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $18 | $64 | $111 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $43 | $78 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $11 | $58 | $105 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $79 | $117 | $155 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $17 | $30 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $9 | $32 | $55 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $44 | $62 | $80 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $56 | $57 | $58 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $82 | $99 | $116 |
| Consultation office straightforward CPT 99241 • Office Visits | $71 | $71 | $71 |
| Consultation office low complexity CPT 99243 • Office Visits | $94 | $108 | $122 |
| Consultation office high complexity CPT 99245 • Office Visits | $172 | $190 | $207 |