| Obstetric ultrasound limited CPT 76815 • Maternity | $34 | $34 | $34 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $49 | $62 | $82 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $5 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $143 | $168 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $142 | $175 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $71 | $81 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $47 | $75 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $92 | $95 | $97 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $77 | $96 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $135 | $136 | $138 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $124 | $134 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $168 | $186 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $81 | $89 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $98 | $105 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $119 | $135 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $33 | $45 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $68 | $95 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $129 | $131 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $127 | $130 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $226 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $157 | $293 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $37 | $86 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $119 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $67 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $63 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $105 | $154 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $189 | $203 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $209 | $247 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $48 | $59 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $97 | $103 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $135 | $138 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $162 | $184 | $215 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $16 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $38 | $48 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $53 | $70 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $10 | $65 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $96 | $123 | $149 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $69 | $120 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $115 | $142 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $160 | $184 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $35 | $82 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $57 | $93 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $81 | $105 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $100 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $110 | $129 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $108 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $92 | $190 | $254 |