| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $81 | $229 | $531 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $27 | $86 | $143 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $107 | $129 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $15 | $20 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $162 | $232 | $368 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $168 | $244 | $306 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $75 | $108 | $153 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $85 | $103 | $110 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $107 | $142 | $199 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $107 | $151 | $221 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $157 | $246 | $328 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $117 | $176 | $268 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $178 | $325 | $407 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $76 | $147 | $211 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $115 | $191 | $240 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $163 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $61 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $47 | $213 | $347 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $187 | $384 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $130 | $191 | $243 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $51 | $244 | $585 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $396 | $574 | $682 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $177 | $263 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $94 | $204 | $252 |
| EMG needle each extremity complete CPT 95886 • Neurology | $113 | $127 | $139 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $131 | $212 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $76 | $145 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $193 | $335 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $206 | $246 | $256 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $214 | $436 | $726 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $101 | $142 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $96 | $157 | $211 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $200 | $299 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $211 | $257 | $381 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $34 | $46 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $69 | $83 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $97 | $130 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $121 | $185 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $167 | $239 | $263 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $98 | $149 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $154 | $178 | $248 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $96 | $219 | $346 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $59 | $74 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $84 | $123 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $121 | $174 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $94 | $156 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $119 | $151 | $213 |
| Consultation office straightforward CPT 99241 • Office Visits | $75 | $75 | $75 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $112 | $265 |