| Obstetric ultrasound complete CPT 76805 • Maternity | $39 | $118 | $323 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $105 | $208 | $676 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $29 | $78 | $155 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $29 | $64 | $99 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $23 | $55 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $98 | $234 | $645 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $101 | $255 | $725 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $44 | $115 | $293 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $30 | $97 | $269 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $76 | $138 | $386 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $40 | $137 | $340 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $133 | $216 | $569 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $115 | $194 | $451 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $113 | $213 | $548 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $103 | $271 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $73 | $148 | $363 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $90 | $156 | $381 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $41 | $89 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $62 | $209 | $554 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $95 | $200 | $522 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $117 | $217 | $519 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $49 | $218 | $448 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $58 | $422 | $982 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $43 | $124 | $353 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $91 | $200 | $608 |
| EMG needle each extremity complete CPT 95886 • Neurology | $35 | $84 | $122 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $80 | $100 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $42 | $114 | $317 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $69 | $157 | $449 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $92 | $222 | $665 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $163 | $321 | $681 |
| EEG monitoring continuous 24 hours CPT 95950 • Neurology | $718 | $718 | $718 |
| EEG monitoring continuous 24 hours with video CPT 95951 • Neurology | $5,257 | $5,257 | $5,257 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $39 | $70 | $101 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $148 | $318 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $85 | $202 | $476 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $154 | $303 | $627 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $29 | $68 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $55 | $99 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $41 | $110 | $260 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $61 | $136 | $366 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $102 | $240 | $515 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $85 | $137 | $280 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $183 | $364 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $234 | $483 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $35 | $51 | $81 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $104 | $220 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $86 | $149 | $331 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $56 | $109 | $228 |