| Obstetric ultrasound limited CPT 76815 • Maternity | $38 | $47 | $54 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $36 | $43 | $57 |
| Interactive complexity add-on CPT 90785 • Mental Health | $7 | $13 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $111 | $167 | $224 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $166 | $172 | $185 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $45 | $70 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $59 | $69 | $85 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $77 | $102 | $120 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $100 | $100 | $100 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $97 | $131 | $166 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $133 | $144 | $162 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $165 | $206 | $248 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $128 | $128 | $128 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $119 | $119 | $119 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $130 | $137 | $152 |
| Group psychotherapy CPT 90853 • Mental Health | $42 | $42 | $42 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $140 | $171 | $203 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $147 | $170 | $215 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $108 | $128 | $169 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $256 | $299 | $320 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $358 | $360 | $362 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $98 | $103 | $115 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $58 | $113 | $141 |
| EMG needle each extremity complete CPT 95886 • Neurology | $70 | $83 | $95 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $77 | $90 | $102 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $142 | $172 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $90 | $131 | $151 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $199 | $223 | $271 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $309 | $326 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $42 | $59 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $68 | $107 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $116 | $151 | $172 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $38 | $139 | $208 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $29 | $38 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $42 | $48 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $54 | $79 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $38 | $87 | $115 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $87 | $145 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $104 | $132 | $159 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $136 | $142 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $135 | $165 | $209 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $71 | $100 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $75 | $84 | $100 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $106 | $109 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $83 | $100 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $93 | $101 | $109 |
| Consultation office straightforward CPT 99241 • Office Visits | $37 | $37 | $37 |
| Consultation office low complexity CPT 99243 • Office Visits | $84 | $110 | $140 |
| Consultation office high complexity CPT 99245 • Office Visits | $214 | $226 | $248 |