| Obstetric ultrasound complete CPT 76805 • Maternity | $53 | $160 | $428 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $94 | $243 | $676 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $34 | $92 | $175 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $41 | $80 | $121 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $25 | $55 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $132 | $263 | $645 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $101 | $335 | $725 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $44 | $135 | $293 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $30 | $132 | $269 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $76 | $171 | $386 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $40 | $160 | $340 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $122 | $305 | $569 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $61 | $189 | $451 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $113 | $263 | $548 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $116 | $271 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $73 | $163 | $363 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $90 | $188 | $381 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $50 | $89 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $15 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $63 | $255 | $554 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $232 | $522 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $138 | $268 | $519 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $69 | $592 | $1,334 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $169 | $561 | $990 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $53 | $111 | $163 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $69 | $267 | $608 |
| EMG needle each extremity complete CPT 95886 • Neurology | $35 | $86 | $139 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $101 | $153 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $62 | $133 | $334 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $81 | $135 | $187 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $169 | $257 | $665 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $132 | $335 | $694 |
| EEG monitoring continuous 24 hours CPT 95950 • Neurology | $642 | $642 | $642 |
| EEG monitoring continuous 24 hours with video CPT 95951 • Neurology | $905 | $905 | $905 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $48 | $83 | $150 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $73 | $154 | $318 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $85 | $267 | $477 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $142 | $297 | $627 |
| Office visit established patient minimal CPT 99211 • Office Visits | $8 | $32 | $68 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $69 | $117 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $60 | $134 | $264 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $61 | $160 | $366 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $95 | $278 | $515 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $83 | $156 | $287 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $195 | $364 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $272 | $483 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $62 | $85 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $60 | $107 | $220 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $96 | $169 | $331 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $64 | $118 | $228 |