| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $97 | $120 | $164 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $13 | $28 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $157 | $201 | $261 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $168 | $206 | $282 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $70 | $96 | $125 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $102 | $111 | $129 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $97 | $125 | $167 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $116 | $162 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $139 | $194 | $250 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $145 | $168 | $216 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $261 | $261 | $261 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $126 | $126 | $126 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $130 | $163 | $204 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $189 | $196 | $209 |
| Group psychotherapy CPT 90853 • Mental Health | $52 | $52 | $53 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $159 | $213 | $266 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $267 | $269 | $270 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $239 | $239 | $239 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $113 | $259 | $333 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $311 | $532 | $753 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $229 | $229 | $229 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $319 | $319 | $319 |
| EMG needle each extremity complete CPT 95886 • Neurology | $83 | $90 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $104 | $104 | $104 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $78 | $108 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $71 | $116 | $207 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $385 | $584 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $91 | $102 | $107 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $158 | $175 | $192 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $192 | $224 | $242 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $252 | $287 | $306 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $28 | $34 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $63 | $68 | $77 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $93 | $100 | $103 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $143 | $152 | $156 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $201 | $207 | $212 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $149 | $161 | $184 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $209 | $229 | $250 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $305 | $326 | $368 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $62 | $67 | $71 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $112 | $118 | $131 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $160 | $170 | $189 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $115 | $120 | $131 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $166 | $175 | $194 |
| Consultation office straightforward CPT 99241 • Office Visits | $57 | $57 | $57 |
| Consultation office low complexity CPT 99243 • Office Visits | $119 | $185 | $225 |
| Consultation office high complexity CPT 99245 • Office Visits | $408 | $408 | $408 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $807 | $1,021 | $1,234 |