| Obstetric ultrasound limited CPT 76815 • Maternity | $71 | $108 | $140 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $52 | $104 | $157 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $17 | $33 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $131 | $235 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $195 | $279 | $363 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $72 | $119 | $141 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $89 | $101 | $129 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $86 | $132 | $183 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $55 | $123 | $162 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $184 | $209 | $251 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $151 | $229 | $278 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $298 | $317 | $336 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $95 | $123 | $147 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $105 | $163 | $217 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $225 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $63 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $7 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $210 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $280 | $436 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $277 | $298 | $318 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $80 | $358 | $706 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $469 | $857 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $60 | $133 | $229 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $215 | $403 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $152 | $228 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $142 | $233 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $93 | $123 | $164 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $112 | $196 | $342 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $208 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $418 | $501 | $584 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $102 | $137 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $145 | $198 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $156 | $221 | $348 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $129 | $237 | $370 |
| Office visit established patient minimal CPT 99211 • Office Visits | $31 | $44 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $60 | $94 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $101 | $150 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $90 | $132 | $170 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $194 | $296 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $139 | $184 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $185 | $255 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $211 | $336 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $53 | $71 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $97 | $138 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $179 | $206 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $100 | $135 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $81 | $169 | $238 |
| Consultation office straightforward CPT 99241 • Office Visits | $50 | $50 | $50 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $144 | $263 |
| Consultation office high complexity CPT 99245 • Office Visits | $30 | $300 | $499 |