| Obstetric ultrasound limited CPT 76815 • Maternity | $35 | $60 | $72 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $40 | $96 | $124 |
| Interactive complexity add-on CPT 90785 • Mental Health | $19 | $24 | $30 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $191 | $251 | $372 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $187 | $254 | $310 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $93 | $99 | $108 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $65 | $89 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $130 | $155 | $205 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $98 | $104 | $114 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $210 | $256 | $302 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $116 | $127 | $137 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $140 | $287 | $434 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $97 | $141 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $126 | $135 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $133 | $137 | $142 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $55 | $72 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $74 | $133 | $192 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $60 | $123 | $173 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $157 | $181 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $78 | $321 | $518 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $365 | $480 | $596 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $58 | $116 | $181 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $217 | $233 | $266 |
| EMG needle each extremity complete CPT 95886 • Neurology | $121 | $124 | $128 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $60 | $74 | $87 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $64 | $150 | $302 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $149 | $177 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $135 | $234 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $139 | $269 | $382 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $76 | $97 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $114 | $132 | $149 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $213 | $322 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $284 | $408 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $19 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $64 | $82 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $65 | $89 | $137 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $95 | $142 | $207 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $155 | $199 | $243 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $125 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $148 | $159 | $171 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $215 | $258 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $87 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $79 | $106 | $130 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $110 | $118 | $130 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $106 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $114 | $134 | $153 |
| Consultation office straightforward CPT 99241 • Office Visits | $56 | $56 | $56 |
| Consultation office low complexity CPT 99243 • Office Visits | $93 | $135 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $208 | $330 | $497 |