| Obstetric ultrasound limited CPT 76815 • Maternity | $62 | $147 | $232 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $14 | $139 | $264 |
| Interactive complexity add-on CPT 90785 • Mental Health | $16 | $33 | $51 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $135 | $365 | $595 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $180 | $423 | $666 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $56 | $157 | $258 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $58 | $147 | $236 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $107 | $205 | $302 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $101 | $200 | $299 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $112 | $307 | $501 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $117 | $236 | $356 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $152 | $316 | $481 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $89 | $163 | $238 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $116 | $221 | $326 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $231 | $341 |
| Group psychotherapy CPT 90853 • Mental Health | $52 | $71 | $91 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $8 | $15 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $42 | $241 | $441 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $20 | $236 | $453 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $20 | $189 | $357 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $122 | $189 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $189 | $212 | $235 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $59 | $216 | $374 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $89 | $177 | $264 |
| EMG needle each extremity complete CPT 95886 • Neurology | $45 | $185 | $325 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $94 | $135 | $176 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $139 | $220 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $163 | $264 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $205 | $235 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $460 | $541 | $622 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $9 | $114 | $164 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $44 | $183 | $254 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $177 | $302 | $378 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $348 | $499 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $38 | $46 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $7 | $74 | $109 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $151 | $182 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $148 | $252 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $219 | $304 | $352 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $8 | $192 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $16 | $270 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $217 | $437 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $69 | $100 | $113 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $57 | $161 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $216 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $9 | $150 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $84 | $236 | $300 |
| Consultation office straightforward CPT 99241 • Office Visits | $76 | $76 | $76 |
| Consultation office low complexity CPT 99243 • Office Visits | $40 | $245 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $291 | $506 | $624 |