| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $44 | $47 | $50 |
| Interactive complexity add-on CPT 90785 • Mental Health | $11 | $11 | $11 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $110 | $110 | $110 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $123 | $123 | $123 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $54 | $54 | $54 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $55 | $55 | $55 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $67 | $67 | $67 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $70 | $70 | $70 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $107 | $107 | $107 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $93 | $93 | $93 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $105 | $105 | $105 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $50 | $50 | $50 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $81 | $81 | $81 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $90 | $90 | $90 |
| Group psychotherapy CPT 90853 • Mental Health | $21 | $21 | $21 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $4 | $4 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $115 | $183 | $251 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $42 | $73 | $104 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $85 | $129 | $173 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $46 | $46 | $46 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $46 | $46 | $46 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $94 | $94 | $94 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $134 | $134 | $134 |
| EMG needle each extremity complete CPT 95886 • Neurology | $37 | $37 | $37 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $32 | $32 | $32 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $64 | $64 | $64 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $65 | $65 | $65 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $151 | $151 | $151 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $57 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $60 | $82 | $103 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $98 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $161 | $167 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $17 | $17 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $35 | $46 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $76 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $84 | $91 | $96 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $113 | $113 | $113 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $79 | $79 | $79 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $107 | $107 | $107 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $159 | $159 | $159 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $31 | $31 | $31 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $57 | $57 | $57 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $82 | $82 | $82 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $57 | $57 | $57 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $84 | $84 | $84 |
| Consultation office straightforward CPT 99241 • Office Visits | $35 | $35 | $35 |
| Consultation office low complexity CPT 99243 • Office Visits | $96 | $96 | $96 |
| Consultation office high complexity CPT 99245 • Office Visits | $175 | $175 | $175 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $476 | $664 | $852 |