| Obstetric ultrasound first trimester CPT 76801 • Maternity | $95 | $103 | $119 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $49 | $90 | $110 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $93 | $144 | $170 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $50 | $61 | $66 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $70 | $84 | $94 |
| Interactive complexity add-on CPT 90785 • Mental Health | $8 | $11 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $106 | $144 | $170 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $133 | $159 | $177 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $69 | $74 | $84 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $65 | $71 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $78 | $97 | $112 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $68 | $75 | $81 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $113 | $129 | $151 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $104 | $119 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $129 | $140 | $145 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $52 | $64 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $85 | $98 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $93 | $103 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $25 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $146 | $146 | $146 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $130 | $130 | $130 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $149 | $149 | $149 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $323 | $323 | $323 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $57 | $271 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $51 | $51 | $51 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $80 | $80 |
| EMG needle each extremity complete CPT 95886 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $53 | $53 | $53 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $46 | $46 | $46 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $135 | $135 | $135 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $177 | $177 | $177 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $289 | $289 | $289 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $49 | $62 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $95 | $107 | $113 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $155 | $164 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $131 | $173 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $21 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $48 | $54 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $47 | $59 | $67 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $70 | $100 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $168 | $177 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $71 | $84 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $121 | $141 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $137 | $187 | $248 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $47 | $50 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $85 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $88 | $118 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $77 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $103 | $121 | $143 |