| Obstetric ultrasound limited CPT 76815 • Maternity | $79 | $88 | $98 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $33 | $70 | $107 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $157 | $172 | $186 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $131 | $143 | $155 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $52 | $57 | $62 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $43 | $47 | $51 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $85 | $89 | $92 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $71 | $78 | $84 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $117 | $128 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $114 | $125 | $135 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $172 | $172 | $172 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $89 | $89 | $89 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $83 | $95 | $107 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $98 | $114 | $131 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $31 | $36 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $80 | $148 | $216 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $154 | $187 | $220 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $152 | $155 | $157 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $67 | $97 | $127 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $104 | $110 | $116 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $41 | $44 | $46 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $30 | $31 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $48 | $49 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $73 | $96 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $66 | $81 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $96 | $119 | $143 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $79 | $87 | $94 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $193 | $280 | $367 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $64 | $72 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $61 | $71 | $80 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $127 | $139 | $151 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $160 | $176 | $192 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $19 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $20 | $39 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $35 | $58 | $102 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $61 | $64 | $66 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $111 | $122 | $133 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $77 | $78 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $118 | $126 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $168 | $175 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $33 | $35 | $38 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $61 | $62 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $84 | $86 | $88 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $60 | $70 | $79 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $87 | $97 | $108 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $104 | $107 | $111 |
| Consultation office high complexity CPT 99245 • Office Visits | $202 | $224 | $246 |