| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $42 | $71 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $90 | $107 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $9 | $17 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $144 | $170 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $162 | $167 | $168 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $77 | $88 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $80 | $96 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $96 | $105 | $129 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $98 | $107 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $154 | $165 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $123 | $134 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $154 | $161 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $61 | $73 | $82 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $124 | $134 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $120 | $146 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $54 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $49 | $88 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $64 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $136 | $146 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $269 | $398 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $66 | $308 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $117 | $135 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $136 | $193 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $82 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $69 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $89 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $114 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $123 | $162 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $217 | $268 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $74 | $82 | $85 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $120 | $123 | $124 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $57 | $140 | $190 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $166 | $204 | $231 |
| Office visit established patient minimal CPT 99211 • Office Visits | $2 | $19 | $25 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $50 | $56 | $59 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $85 | $95 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $12 | $101 | $135 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $163 | $181 | $190 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $103 | $113 | $118 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $154 | $160 | $163 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $19 | $181 | $239 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $53 | $57 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $76 | $84 | $88 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $100 | $126 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $79 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $110 | $126 | $136 |
| Consultation office straightforward CPT 99241 • Office Visits | $35 | $35 | $35 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $121 | $159 |
| Consultation office high complexity CPT 99245 • Office Visits | $251 | $269 | $285 |