| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $154 | $182 | $221 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $71 | $107 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $135 | $216 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $18 | $36 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $163 | $230 | $335 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $183 | $248 | $371 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $68 | $108 | $164 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $114 | $168 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $90 | $135 | $218 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $80 | $130 | $213 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $151 | $239 | $326 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $165 | $279 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $243 | $341 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $63 | $107 | $163 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $97 | $162 | $239 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $167 | $249 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $46 | $65 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $134 | $230 | $326 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $207 | $314 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $216 | $311 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $135 | $267 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $512 | $973 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $92 | $159 | $274 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $68 | $114 | $195 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $75 | $108 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $65 | $127 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $41 | $104 | $159 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $49 | $125 | $190 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $63 | $164 | $254 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $171 | $385 | $700 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $108 | $169 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $170 | $173 | $175 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $123 | $258 | $383 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $183 | $332 | $475 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $29 | $47 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $66 | $100 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $116 | $175 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $96 | $133 | $175 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $185 | $257 | $330 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $144 | $234 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $230 | $274 | $317 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $149 | $318 | $467 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $70 | $80 | $91 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $107 | $167 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $150 | $241 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $108 | $168 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $177 | $246 |
| Consultation office straightforward CPT 99241 • Office Visits | $61 | $61 | $61 |
| Consultation office low complexity CPT 99243 • Office Visits | $18 | $141 | $224 |