| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $50 | $94 | $123 |
| Interactive complexity add-on CPT 90785 • Mental Health | $13 | $16 | $19 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $157 | $176 | $196 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $194 | $199 | $205 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $78 | $82 | $87 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $66 | $82 | $98 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $82 | $99 | $116 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $99 | $114 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $145 | $191 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $127 | $150 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $120 | $160 | $199 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $56 | $76 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $104 | $122 | $141 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $123 | $145 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $32 | $34 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $173 | $192 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $180 | $180 | $180 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $178 | $178 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $69 | $398 | $518 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $569 | $589 | $596 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $88 | $88 | $88 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $114 | $114 | $114 |
| EMG needle each extremity complete CPT 95886 • Neurology | $53 | $96 | $128 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $54 | $54 | $54 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $93 | $112 | $131 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $111 | $130 | $150 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $177 | $217 | $257 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $318 | $364 | $409 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $86 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $108 | $140 | $149 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $175 | $224 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $239 | $296 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $28 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $54 | $66 | $76 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $106 | $122 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $108 | $145 | $172 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $152 | $213 | $243 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $92 | $115 | $138 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $148 | $168 | $187 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $230 | $253 | $276 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $54 | $55 | $56 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $99 | $102 | $105 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $92 | $117 | $142 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $66 | $83 | $99 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $145 | $146 | $146 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $167 | $167 | $167 |
| Consultation office high complexity CPT 99245 • Office Visits | $306 | $306 | $306 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $739 | $807 | $829 |