| Obstetric ultrasound limited CPT 76815 • Maternity | $36 | $63 | $85 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $41 | $69 | $98 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $15 | $19 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $106 | $196 | $308 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $156 | $248 | $423 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $69 | $123 | $223 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $60 | $125 | $229 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $67 | $149 | $297 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $85 | $93 | $107 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $134 | $200 | $246 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $228 | $381 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $145 | $291 | $463 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $70 | $162 | $222 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $101 | $132 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $206 | $336 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $39 | $64 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $10 | $16 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $255 | $378 | $501 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $38 | $144 | $251 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $208 | $314 | $420 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $364 | $652 | $1,165 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $860 | $1,383 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $122 | $276 | $385 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $93 | $229 | $462 |
| EMG needle each extremity complete CPT 95886 • Neurology | $60 | $174 | $311 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $99 | $203 | $307 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $154 | $279 | $389 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $86 | $143 | $224 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $174 | $322 | $613 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $339 | $567 | $973 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $99 | $171 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $112 | $183 | $242 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $130 | $144 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $272 | $357 | $453 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $32 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $62 | $102 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $50 | $107 | $169 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $111 | $139 | $181 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $141 | $242 | $329 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $149 | $231 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $110 | $197 | $311 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $163 | $241 | $457 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $54 | $71 | $89 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $120 | $163 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $84 | $157 | $235 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $105 | $139 | $165 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $148 | $242 |
| Consultation office straightforward CPT 99241 • Office Visits | $42 | $42 | $42 |
| Consultation office low complexity CPT 99243 • Office Visits | $36 | $168 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $79 | $286 | $510 |