| Obstetric ultrasound limited CPT 76815 • Maternity | $44 | $70 | $81 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $64 | $101 | $163 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $13 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $141 | $211 | $339 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $153 | $224 | $283 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $103 | $141 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $39 | $65 | $94 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $84 | $115 | $183 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $99 | $153 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $113 | $127 | $134 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $175 | $248 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $182 | $298 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $77 | $147 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $83 | $127 | $217 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $105 | $184 | $264 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $24 | $26 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $115 | $143 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $114 | $143 | $181 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $127 | $174 | $264 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $258 | $431 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $379 | $429 | $501 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $116 | $122 | $125 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $83 | $147 | $179 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $98 | $141 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $93 | $96 | $99 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $67 | $118 | $189 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $72 | $81 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $78 | $177 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $108 | $285 | $432 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $50 | $69 | $99 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $74 | $105 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $121 | $193 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $126 | $230 | $360 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $32 | $42 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $37 | $43 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $45 | $72 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $87 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $30 | $108 | $150 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $66 | $132 | $239 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $134 | $191 | $239 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $128 | $203 | $277 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $55 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $55 | $75 | $100 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $111 | $139 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $85 | $100 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $93 | $111 | $144 |
| Consultation office straightforward CPT 99241 • Office Visits | $37 | $37 | $37 |
| Consultation office low complexity CPT 99243 • Office Visits | $96 | $122 | $165 |
| Consultation office high complexity CPT 99245 • Office Visits | $214 | $240 | $302 |