| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $65 | $79 | $93 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $12 | $14 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $126 | $144 | $162 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $140 | $147 | $154 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $62 | $62 | $63 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $65 | $66 | $67 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $83 | $83 | $84 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $76 | $83 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $120 | $123 | $126 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $101 | $105 | $109 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $97 | $114 | $131 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $58 | $63 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $90 | $101 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $81 | $93 | $105 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $24 | $25 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $154 | $154 | $154 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $127 | $127 | $127 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $121 | $121 | $121 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $295 | $319 | $343 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $57 | $211 | $366 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $66 | $66 | $66 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $82 | $82 | $82 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $80 | $117 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $92 | $92 | $92 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $48 | $75 | $102 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $60 | $91 | $122 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $106 | $106 | $106 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $186 | $186 | $186 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $65 | $69 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $75 | $136 | $190 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $159 | $205 | $228 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $200 | $211 | $223 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $18 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $42 | $44 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $92 | $116 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $148 | $190 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $140 | $183 | $228 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $88 | $99 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $134 | $151 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $179 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $41 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $69 | $71 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $102 | $106 | $109 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $71 | $88 | $105 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $105 | $105 | $106 |
| Consultation office straightforward CPT 99241 • Office Visits | $32 | $32 | $32 |
| Consultation office low complexity CPT 99243 • Office Visits | $119 | $119 | $119 |
| Consultation office high complexity CPT 99245 • Office Visits | $187 | $187 | $187 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $586 | $586 | $586 |