| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $68 | $139 | $211 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $35 | $51 | $67 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $41 | $59 | $78 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $9 | $13 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $121 | $132 | $142 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $136 | $166 | $182 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $55 | $63 | $70 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $46 | $55 | $64 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $83 | $87 | $91 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $73 | $74 | $76 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $118 | $133 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $115 | $123 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $167 | $204 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $58 | $82 | $105 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $88 | $89 | $90 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $104 | $114 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $25 | $35 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $85 | $94 | $103 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $111 | $149 | $186 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $107 | $109 | $112 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $301 | $327 | $353 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $60 | $235 | $409 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $86 | $106 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $65 | $117 | $143 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $67 | $92 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $94 | $103 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $103 | $112 | $127 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $66 | $66 | $66 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $85 | $126 | $167 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $303 | $331 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $39 | $60 | $79 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $59 | $71 | $83 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $137 | $138 | $140 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $128 | $179 | $219 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $15 | $19 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $35 | $46 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $38 | $55 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $17 | $54 | $114 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $92 | $154 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $90 | $109 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $112 | $130 | $147 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $150 | $173 | $217 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $73 | $78 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $107 | $111 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $73 | $77 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $104 | $114 |
| Consultation office straightforward CPT 99241 • Office Visits | $51 | $51 | $51 |
| Consultation office low complexity CPT 99243 • Office Visits | $54 | $97 | $131 |