| Obstetric ultrasound limited CPT 76815 • Maternity | $35 | $77 | $145 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $36 | $56 | $98 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $16 | $25 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $171 | $200 | $227 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $166 | $258 | $363 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $65 | $96 | $137 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $40 | $79 | $94 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $86 | $152 | $216 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $89 | $149 | $211 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $131 | $207 | $324 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $115 | $192 | $248 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $248 | $273 | $298 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $110 | $129 | $147 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $80 | $145 | $217 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $92 | $180 | $264 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $34 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $97 | $200 | $259 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $181 | $196 | $207 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $194 | $287 | $390 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $66 | $188 | $436 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $228 | $511 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $33 | $120 | $207 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $104 | $126 | $148 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $101 | $137 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $155 | $233 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $51 | $87 | $133 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $139 | $181 | $229 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $209 | $283 | $454 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $341 | $412 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $74 | $105 | $144 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $121 | $161 | $210 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $166 | $243 | $323 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $208 | $262 | $295 |
| Office visit established patient minimal CPT 99211 • Office Visits | $21 | $26 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $50 | $62 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $76 | $104 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $101 | $127 | $156 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $145 | $182 | $207 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $95 | $145 | $203 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $165 | $197 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $236 | $302 | $401 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $49 | $57 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $97 | $125 | $154 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $160 | $205 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $105 | $132 | $154 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $109 | $130 | $155 |
| Consultation office straightforward CPT 99241 • Office Visits | $42 | $42 | $42 |
| Consultation office low complexity CPT 99243 • Office Visits | $36 | $126 | $191 |
| Consultation office high complexity CPT 99245 • Office Visits | $248 | $340 | $528 |