| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $89 | $95 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $14 | $21 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $130 | $166 | $247 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $132 | $244 | $398 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $61 | $105 | $178 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $30 | $97 | $182 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $100 | $137 | $201 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $35 | $123 | $231 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $122 | $157 | $209 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $70 | $122 | $163 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $113 | $209 | $369 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $100 | $177 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $105 | $154 | $243 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $90 | $148 | $251 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $44 | $62 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $53 | $115 | $185 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $92 | $149 | $200 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $117 | $188 | $303 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $297 | $449 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $58 | $370 | $554 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $57 | $83 | $108 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $69 | $114 | $157 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $83 | $117 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $74 | $89 | $108 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $75 | $145 | $291 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $110 | $137 | $181 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $114 | $207 | $301 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $163 | $369 | $759 |
| EEG monitoring continuous 24 hours CPT 95950 • Neurology | $854 | $854 | $854 |
| EEG monitoring continuous 24 hours with video CPT 95951 • Neurology | $5,680 | $5,680 | $5,680 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $64 | $114 | $215 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $73 | $180 | $311 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $108 | $248 | $403 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $142 | $206 | $306 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $31 | $50 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $62 | $108 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $60 | $86 | $126 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $74 | $187 | $309 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $140 | $268 | $413 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $114 | $167 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $141 | $186 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $279 | $485 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $55 | $87 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $79 | $98 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $75 | $105 | $141 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $87 | $153 | $254 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $82 | $160 | $303 |
| Consultation office straightforward CPT 99241 • Office Visits | $120 | $120 | $120 |
| Consultation office low complexity CPT 99243 • Office Visits | $73 | $123 | $166 |