| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $32 | $34 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $93 | $104 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $6 | $6 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $143 | $162 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $148 | $170 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $76 | $87 | $93 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $51 | $85 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $99 | $119 | $130 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $83 | $104 | $116 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $98 | $117 | $136 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $123 | $133 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $190 | $204 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $83 | $105 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $98 | $120 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $125 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $37 | $47 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $166 | $166 | $166 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $95 | $159 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $134 | $136 | $139 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $210 | $288 | $367 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $236 | $236 | $236 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $95 | $103 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $47 | $123 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $48 | $73 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $83 | $114 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $42 | $62 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $74 | $104 | $134 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $191 | $222 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $226 | $255 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $55 | $67 | $74 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $111 | $112 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $121 | $142 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $116 | $162 | $188 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $27 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $28 | $41 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $64 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $75 | $110 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $151 | $164 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $97 | $152 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $148 | $150 | $152 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $168 | $200 | $218 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $44 | $79 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $75 | $115 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $86 | $115 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $74 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $114 | $124 | $130 |
| Consultation office straightforward CPT 99241 • Office Visits | $38 | $38 | $38 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $86 | $143 |
| Consultation office high complexity CPT 99245 • Office Visits | $255 | $262 | $272 |