| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $37 | $41 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $63 | $72 | $98 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $20 | $29 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $126 | $244 | $347 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $157 | $288 | $402 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $70 | $126 | $171 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $124 | $162 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $83 | $128 | $227 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $90 | $143 | $205 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $128 | $200 | $333 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $187 | $260 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $144 | $256 | $311 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $82 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $102 | $161 | $208 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $105 | $186 | $245 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $50 | $61 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $71 | $252 | $343 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $65 | $150 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $214 | $287 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $284 | $348 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $51 | $53 | $58 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $116 | $116 | $116 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $84 | $183 | $255 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $157 | $211 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $103 | $171 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $67 | $170 | $247 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $206 | $297 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $128 | $182 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $108 | $410 | $624 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $41 | $55 | $85 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $41 | $67 | $120 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $41 | $139 | $184 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $41 | $186 | $235 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $32 | $41 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $29 | $37 | $41 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $41 | $65 | $96 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $41 | $96 | $136 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $41 | $70 | $127 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $57 | $115 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $41 | $79 | $156 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $41 | $115 | $230 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $41 | $42 | $45 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $49 | $82 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $41 | $75 | $118 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $49 | $83 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $161 | $210 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $41 | $106 | $228 |
| Consultation office high complexity CPT 99245 • Office Visits | $80 | $318 | $468 |