| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $35 | $71 | $132 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $19 | $37 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $132 | $225 | $434 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $101 | $283 | $488 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $61 | $104 | $205 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $20 | $91 | $189 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $84 | $132 | $271 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $40 | $115 | $240 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $117 | $244 | $401 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $70 | $164 | $319 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $109 | $221 | $386 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $102 | $189 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $73 | $132 | $255 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $90 | $140 | $266 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $45 | $73 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $7 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $89 | $204 | $372 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $168 | $276 | $355 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $139 | $375 | $938 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $49 | $362 | $868 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $140 | $326 | $550 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $57 | $152 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $69 | $183 | $396 |
| EMG needle each extremity complete CPT 95886 • Neurology | $35 | $100 | $240 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $96 | $209 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $50 | $125 | $282 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $69 | $162 | $339 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $99 | $235 | $444 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $138 | $414 | $725 |
| EEG monitoring continuous 24 hours CPT 95950 • Neurology | $164 | $164 | $164 |
| EEG monitoring continuous 24 hours with video CPT 95951 • Neurology | $3,397 | $3,397 | $3,397 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $57 | $83 | $117 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $87 | $152 | $285 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $122 | $199 | $426 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $154 | $256 | $562 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $26 | $60 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $51 | $88 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $32 | $81 | $198 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $71 | $134 | $327 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $95 | $190 | $459 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $113 | $180 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $114 | $166 | $215 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $143 | $215 | $287 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $80 | $189 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $47 | $107 | $199 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $75 | $117 | $196 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $87 | $137 | $254 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $82 | $144 | $233 |
| Consultation office straightforward CPT 99241 • Office Visits | $90 | $90 | $90 |
| Consultation office low complexity CPT 99243 • Office Visits | $73 | $132 | $286 |