| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $62 | $62 | $62 |
| Interactive complexity add-on CPT 90785 • Mental Health | $16 | $16 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $153 | $161 | $165 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $169 | $169 | $169 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $69 | $71 | $75 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $77 | $77 | $77 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $82 | $90 | $99 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $97 | $97 | $97 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $123 | $136 | $149 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $127 | $127 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $106 | $130 | $155 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $74 | $74 | $74 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $109 | $109 | $109 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $113 | $113 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $30 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $68 | $68 | $68 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $127 | $127 | $127 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $119 | $119 | $119 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $62 | $62 | $62 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $463 | $463 | $463 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $95 | $95 | $95 |
| EMG needle each extremity complete CPT 95886 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $58 | $58 | $58 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $87 | $87 | $87 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $117 | $117 | $117 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $204 | $204 | $204 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $54 | $65 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $81 | $93 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $117 | $147 | $175 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $190 | $201 | $222 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $24 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $24 | $31 | $41 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $55 | $57 | $58 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $85 | $89 | $91 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $119 | $126 | $132 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $80 | $89 | $109 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $130 | $139 | $147 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $173 | $188 | $216 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $41 | $42 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $67 | $77 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $95 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $78 | $78 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $109 | $114 |
| Consultation office straightforward CPT 99241 • Office Visits | $51 | $51 | $51 |
| Consultation office low complexity CPT 99243 • Office Visits | $132 | $132 | $132 |
| Consultation office high complexity CPT 99245 • Office Visits | $207 | $207 | $207 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $589 | $589 | $589 |