| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $37 | $82 | $129 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $14 | $19 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $160 | $169 | $174 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $132 | $169 | $188 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $66 | $66 | $66 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $44 | $44 | $44 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $78 | $78 | $78 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $72 | $72 | $72 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $126 | $126 | $126 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $116 | $116 | $116 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $177 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $92 | $92 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $85 | $85 | $85 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $108 | $108 | $108 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $30 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $145 | $183 | $203 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $154 | $167 | $173 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $120 | $143 | $155 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $354 | $440 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $54 | $353 | $502 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $49 | $118 | $153 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $105 | $146 | $213 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $91 | $116 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $55 | $99 | $120 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $123 | $140 | $148 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $64 | $116 | $179 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $193 | $221 | $235 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $122 | $300 | $389 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $67 | $85 | $94 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $97 | $124 | $137 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $123 | $182 | $211 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $189 | $224 | $264 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $20 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $39 | $50 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $83 | $93 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $92 | $96 | $102 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $132 | $166 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $95 | $119 | $131 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $129 | $161 | $178 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $190 | $238 | $262 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $46 | $51 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $85 | $93 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $99 | $122 | $134 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $68 | $85 | $93 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $99 | $125 | $138 |
| Consultation office straightforward CPT 99241 • Office Visits | $33 | $33 | $33 |
| Consultation office low complexity CPT 99243 • Office Visits | $124 | $137 | $160 |
| Consultation office high complexity CPT 99245 • Office Visits | $193 | $258 | $291 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $628 | $741 | $798 |