| Obstetric ultrasound limited CPT 76815 • Maternity | $72 | $83 | $104 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $36 | $80 | $158 |
| Interactive complexity add-on CPT 90785 • Mental Health | $16 | $22 | $28 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $152 | $199 | $292 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $166 | $207 | $288 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $97 | $131 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $89 | $118 | $146 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $90 | $132 | $174 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $131 | $150 | $169 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $109 | $183 | $258 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $150 | $197 | $243 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $152 | $212 | $272 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $97 | $129 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $94 | $143 | $191 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $126 | $162 | $198 |
| Group psychotherapy CPT 90853 • Mental Health | $47 | $50 | $53 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $130 | $169 | $209 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $15 | $127 | $239 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $171 | $213 | $256 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $108 | $278 | $447 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $524 | $595 | $667 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $134 | $162 | $218 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $170 | $186 | $195 |
| EMG needle each extremity complete CPT 95886 • Neurology | $54 | $76 | $99 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $108 | $141 | $175 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $135 | $164 | $222 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $68 | $167 | $266 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $125 | $136 | $147 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $220 | $221 | $221 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $75 | $96 | $136 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $114 | $154 | $193 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $163 | $213 | $301 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $183 | $260 | $381 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $30 | $56 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $55 | $64 | $82 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $76 | $100 | $137 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $172 | $196 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $154 | $211 | $267 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $109 | $149 | $189 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $150 | $203 | $255 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $180 | $257 | $369 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $56 | $64 | $73 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $95 | $134 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $137 | $193 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $83 | $108 | $133 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $86 | $133 | $195 |
| Consultation office straightforward CPT 99241 • Office Visits | $57 | $57 | $57 |
| Consultation office low complexity CPT 99243 • Office Visits | $10 | $117 | $224 |
| Consultation office high complexity CPT 99245 • Office Visits | $29 | $239 | $409 |