| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $35 | $44 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $26 | $36 | $52 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $16 | $25 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $135 | $199 | $337 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $121 | $198 | $274 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $112 | $163 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $58 | $89 | $115 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $107 | $137 | $217 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $97 | $119 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $127 | $194 | $324 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $103 | $167 | $240 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $134 | $203 | $298 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $70 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $99 | $145 | $261 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $80 | $137 | $257 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $45 | $73 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $8 | $102 | $226 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $22 | $171 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $15 | $138 | $277 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $142 | $200 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $200 | $425 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $118 | $142 | $165 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $76 | $138 | $170 |
| EMG needle each extremity complete CPT 95886 • Neurology | $45 | $83 | $131 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $19 | $33 | $47 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $86 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $140 | $228 | $345 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $78 | $227 | $454 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $185 | $450 | $753 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $6 | $84 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $66 | $123 | $182 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $11 | $126 | $219 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $73 | $184 | $360 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $22 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $59 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $69 | $70 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $111 | $210 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $44 | $102 | $150 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $44 | $87 | $139 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $174 | $222 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $16 | $148 | $273 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $56 | $69 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $9 | $75 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $44 | $89 | $143 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $95 | $113 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $132 | $172 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| Consultation office low complexity CPT 99243 • Office Visits | $31 | $104 | $168 |
| Consultation office high complexity CPT 99245 • Office Visits | $143 | $299 | $445 |