| Obstetric ultrasound limited CPT 76815 • Maternity | $40 | $41 | $42 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $75 | $85 | $104 |
| Interactive complexity add-on CPT 90785 • Mental Health | $9 | $13 | $17 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $136 | $183 | $206 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $178 | $200 | $238 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $53 | $81 | $100 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $52 | $85 | $111 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $95 | $118 | $141 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $83 | $93 | $103 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $131 | $140 | $150 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $158 | $183 | $208 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $100 | $134 | $167 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $60 | $60 | $61 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $77 | $88 | $99 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $132 | $156 | $180 |
| Group psychotherapy CPT 90853 • Mental Health | $19 | $34 | $49 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $184 | $217 | $250 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $42 | $148 | $245 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $152 | $170 | $189 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $304 | $350 | $421 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $46 | $208 | $370 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $57 | $91 | $107 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $60 | $121 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $72 | $76 | $79 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $77 | $80 | $83 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $44 | $83 | $104 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $53 | $55 | $57 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $86 | $127 | $168 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $96 | $177 | $259 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $92 | $99 | $103 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $110 | $120 | $130 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $42 | $134 | $184 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $42 | $165 | $286 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $23 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $51 | $62 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $39 | $69 | $95 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $111 | $132 | $149 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $154 | $174 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $52 | $100 | $148 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $80 | $122 | $164 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $176 | $236 | $292 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $35 | $41 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $108 | $121 | $140 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $107 | $134 | $154 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $109 | $121 | $140 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $126 | $144 | $157 |
| Consultation office straightforward CPT 99241 • Office Visits | $53 | $53 | $53 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $131 | $203 |
| Consultation office high complexity CPT 99245 • Office Visits | $269 | $303 | $370 |