| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $70 | $78 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $11 | $12 | $12 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $102 | $140 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $124 | $150 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $53 | $76 | $102 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $76 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $68 | $98 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $68 | $89 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $113 | $125 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $97 | $114 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $129 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $51 | $60 | $70 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $81 | $83 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $86 | $122 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $20 | $25 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $115 | $140 | $165 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $110 | $139 | $169 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $110 | $110 | $110 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $297 | $329 | $360 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $353 | $366 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $55 | $55 | $55 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $141 | $141 | $141 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $42 | $42 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $34 | $34 | $34 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $53 | $53 | $53 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $89 | $89 | $89 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $248 | $248 | $248 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $18 | $48 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $87 | $99 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $148 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $153 | $225 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $20 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $48 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $42 | $64 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $75 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $91 | $135 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $18 | $66 | $97 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $18 | $100 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $18 | $111 | $165 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $18 | $32 | $47 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $18 | $55 | $73 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $18 | $69 | $103 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $18 | $56 | $75 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $111 | $143 |
| Consultation office straightforward CPT 99241 • Office Visits | $27 | $27 | $27 |
| Consultation office low complexity CPT 99243 • Office Visits | $79 | $91 | $102 |
| Consultation office high complexity CPT 99245 • Office Visits | $184 | $193 | $202 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $504 | $609 | $689 |