| Obstetric ultrasound limited CPT 76815 • Maternity | $63 | $67 | $70 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $30 | $79 | $126 |
| Interactive complexity add-on CPT 90785 • Mental Health | $25 | $28 | $31 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $118 | $229 | $288 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $152 | $228 | $319 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $93 | $117 | $141 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $91 | $111 | $132 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $144 | $161 | $188 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $143 | $155 | $167 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $132 | $213 | $281 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $190 | $215 | $240 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $230 | $262 | $293 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $110 | $125 | $140 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $106 | $156 | $207 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $147 | $180 | $214 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $50 | $56 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $236 | $264 | $293 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $107 | $170 | $280 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $225 | $233 | $241 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $209 | $504 | $692 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $99 | $150 | $235 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $109 | $148 | $207 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $158 | $161 | $167 |
| EMG needle each extremity complete CPT 95886 • Neurology | $129 | $160 | $189 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $109 | $115 | $121 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $101 | $121 | $152 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $139 | $223 | $284 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $156 | $225 | $281 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $489 | $534 | $596 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $85 | $106 | $129 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $126 | $148 | $161 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $162 | $211 | $267 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $177 | $272 | $423 |
| Office visit established patient minimal CPT 99211 • Office Visits | $12 | $31 | $46 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $62 | $91 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $69 | $106 | $152 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $112 | $141 | $221 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $158 | $204 | $231 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $90 | $143 | $209 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $150 | $215 | $284 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $263 | $419 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $45 | $63 | $81 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $74 | $110 | $150 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $105 | $157 | $216 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $94 | $125 | $150 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $153 | $221 |
| Consultation office straightforward CPT 99241 • Office Visits | $54 | $54 | $54 |
| Consultation office low complexity CPT 99243 • Office Visits | $118 | $170 | $201 |
| Consultation office high complexity CPT 99245 • Office Visits | $223 | $326 | $463 |