| Obstetric ultrasound limited CPT 76815 • Maternity | $32 | $70 | $98 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $37 | $79 | $104 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $9 | $13 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $115 | $163 | $186 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $124 | $183 | $214 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $57 | $75 | $91 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $51 | $70 | $86 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $76 | $103 | $121 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $73 | $79 | $84 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $114 | $154 | $178 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $98 | $130 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $118 | $118 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $57 | $57 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $91 | $99 | $107 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $95 | $113 | $131 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $30 | $36 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $80 | $144 | $181 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $102 | $135 | $154 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $90 | $136 | $152 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $134 | $345 | $474 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $172 | $405 | $554 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $49 | $58 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $128 | $136 | $144 |
| EMG needle each extremity complete CPT 95886 • Neurology | $41 | $81 | $112 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $82 | $101 | $115 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $81 | $115 | $131 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $70 | $117 | $169 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $66 | $142 | $205 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $97 | $282 | $367 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $42 | $72 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $65 | $105 | $138 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $138 | $180 | $211 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $35 | $168 | $253 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $27 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $49 | $66 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $78 | $96 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $66 | $118 | $147 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $121 | $157 | $188 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $78 | $86 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $117 | $121 | $126 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $166 | $175 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $40 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $67 | $73 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $88 | $99 | $110 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $61 | $74 | $79 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $90 | $106 | $111 |
| Consultation office straightforward CPT 99241 • Office Visits | $41 | $41 | $41 |
| Consultation office low complexity CPT 99243 • Office Visits | $5 | $95 | $121 |
| Consultation office high complexity CPT 99245 • Office Visits | $190 | $221 | $246 |