| Obstetric ultrasound limited CPT 76815 • Maternity | $59 | $71 | $80 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $95 | $144 | $214 |
| Interactive complexity add-on CPT 90785 • Mental Health | $17 | $21 | $25 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $203 | $238 | $261 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $216 | $247 | $282 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $91 | $100 | $118 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $78 | $101 | $131 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $104 | $142 | $203 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $107 | $124 | $139 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $156 | $181 | $231 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $147 | $184 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $178 | $221 | $261 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $84 | $95 | $116 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $115 | $158 | $215 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $162 | $215 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $58 | $113 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $61 | $1,329 | $6,072 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $257 | $502 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $122 | $408 | $938 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $86 | $372 | $617 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $86 | $497 | $1,029 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $53 | $94 | $115 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $119 | $164 | $217 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $86 | $165 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $81 | $120 | $152 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $99 | $123 | $158 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $87 | $155 | $230 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $207 | $258 | $302 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $314 | $395 | $486 |
| 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 | $60 | $78 | $118 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $112 | $172 | $199 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $140 | $206 | $297 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $174 | $248 | $359 |
| Office visit established patient minimal CPT 99211 • Office Visits | $14 | $34 | $65 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $41 | $53 | $59 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $81 | $113 | $147 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $128 | $166 | $208 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $144 | $222 | $293 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $82 | $136 | $182 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $129 | $165 | $217 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $259 | $317 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $57 | $70 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $60 | $90 | $114 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $117 | $138 | $164 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $80 | $91 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $114 | $143 | $168 |
| Consultation office straightforward CPT 99241 • Office Visits | $90 | $90 | $90 |