| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $96 | $205 | $380 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $47 | $89 | $175 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $32 | $80 | $198 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $12 | $30 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $120 | $196 | $353 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $124 | $208 | $401 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $64 | $91 | $166 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $42 | $74 | $146 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $83 | $123 | $187 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $120 | $229 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $121 | $178 | $325 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $111 | $159 | $291 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $167 | $183 | $199 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $80 | $90 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $81 | $126 | $230 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $105 | $144 | $240 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $39 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $7 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $96 | $185 | $325 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $121 | $194 | $307 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $102 | $169 | $319 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $52 | $234 | $852 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $299 | $993 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $45 | $85 | $238 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $36 | $107 | $150 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $97 | $201 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $39 | $97 | $189 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $50 | $119 | $235 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $57 | $118 | $283 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $106 | $199 | $370 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $96 | $253 | $605 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $50 | $84 | $155 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $75 | $102 | $121 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $128 | $162 | $185 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $164 | $245 | $478 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $25 | $70 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $61 | $122 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $50 | $73 | $94 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $131 | $276 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $109 | $187 | $386 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $86 | $124 | $247 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $132 | $164 | $274 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $225 | $398 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $70 | $192 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $64 | $87 | $192 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $130 | $247 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $70 | $104 | $192 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $135 | $241 |
| Consultation office straightforward CPT 99241 • Office Visits | $46 | $46 | $46 |
| Consultation office low complexity CPT 99243 • Office Visits | $0 | $123 | $247 |