| Obstetric ultrasound limited CPT 76815 • Maternity | $49 | $53 | $57 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $42 | $94 | $122 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $106 | $132 | $144 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $119 | $198 | $263 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $51 | $55 | $60 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $34 | $51 | $79 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $76 | $86 | $102 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $65 | $84 | $94 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $106 | $121 | $133 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $91 | $104 | $129 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $117 | $159 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $83 | $83 | $83 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $91 | $103 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $99 | $123 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $25 | $35 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $77 | $104 | $130 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $125 | $161 | $197 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $95 | $121 | $146 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $49 | $155 | $387 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $88 | $185 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $39 | $57 | $74 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $71 | $82 | $93 |
| EMG needle each extremity complete CPT 95886 • Neurology | $38 | $64 | $86 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $49 | $80 | $110 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $110 | $118 | $135 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $78 | $92 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $90 | $95 | $99 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $176 | $263 | $351 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $43 | $62 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $109 | $170 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $114 | $186 | $277 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $206 | $304 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $19 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $26 | $46 | $73 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $55 | $88 | $123 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $63 | $100 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $118 | $210 | $301 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $73 | $79 | $85 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $116 | $151 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $213 | $264 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $34 | $55 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $60 | $84 | $120 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $85 | $105 | $144 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $61 | $82 | $117 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $89 | $121 | $148 |
| Consultation office straightforward CPT 99241 • Office Visits | $30 | $30 | $30 |
| Consultation office low complexity CPT 99243 • Office Visits | $99 | $106 | $112 |
| Consultation office high complexity CPT 99245 • Office Visits | $196 | $200 | $203 |