| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $56 | $120 | $203 |
| Interactive complexity add-on CPT 90785 • Mental Health | $13 | $25 | $30 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $150 | $215 | $278 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $205 | $292 | $350 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $78 | $117 | $136 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $66 | $118 | $140 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $82 | $156 | $202 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $84 | $137 | $177 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $204 | $270 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $188 | $234 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $120 | $191 | $262 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $55 | $79 | $126 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $104 | $190 | $245 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $102 | $190 | $226 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $62 | $87 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $328 | $338 | $357 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $44 | $219 | $305 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $215 | $245 | $262 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $69 | $538 | $737 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $112 | $602 | $846 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $229 | $256 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $157 | $157 | $157 |
| EMG needle each extremity complete CPT 95886 • Neurology | $104 | $164 | $189 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $104 | $169 | $202 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $129 | $215 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $150 | $266 | $348 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $145 | $295 | $410 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $318 | $488 | $621 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $86 | $132 | $155 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $108 | $188 | $224 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $189 | $299 | $384 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $64 | $313 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $43 | $57 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $47 | $67 | $90 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $95 | $127 | $152 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $123 | $204 | $251 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $185 | $263 | $302 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $92 | $176 | $213 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $148 | $245 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $326 | $427 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $56 | $97 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $105 | $134 | $152 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $92 | $181 | $220 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $66 | $126 | $153 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $146 | $210 | $254 |
| Consultation office straightforward CPT 99241 • Office Visits | $83 | $83 | $83 |
| Consultation office low complexity CPT 99243 • Office Visits | $158 | $209 | $287 |
| Consultation office high complexity CPT 99245 • Office Visits | $358 | $455 | $525 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,262 | $1,310 | $1,407 |