| Obstetric ultrasound limited CPT 76815 • Maternity | $36 | $45 | $54 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $62 | $72 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $8 | $14 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $99 | $119 | $129 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $140 | $152 | $170 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $83 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $52 | $73 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $69 | $92 | $110 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $61 | $88 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $111 | $128 | $148 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $72 | $120 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $161 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $47 | $61 | $72 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $69 | $106 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $119 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $40 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $2 | $3 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $71 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $20 | $67 | $114 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $13 | $80 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $37 | $177 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $90 | $272 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $36 | $88 | $118 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $82 | $145 | $183 |
| EMG needle each extremity complete CPT 95886 • Neurology | $42 | $63 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $66 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $75 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $28 | $36 | $44 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $35 | $86 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $69 | $225 | $322 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $49 | $59 | $74 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $62 | $104 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $112 | $121 | $139 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $138 | $164 | $188 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $25 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $34 | $41 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $43 | $51 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $60 | $75 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $140 | $153 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $99 | $134 | $152 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $20 | $86 | $152 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $96 | $141 | $212 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $27 | $76 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $54 | $80 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $71 | $91 | $115 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $50 | $79 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $51 | $95 | $130 |
| Consultation office straightforward CPT 99241 • Office Visits | $35 | $35 | $35 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $64 | $119 |
| Consultation office high complexity CPT 99245 • Office Visits | $92 | $168 | $272 |