| Obstetric ultrasound limited CPT 76815 • Maternity | $43 | $80 | $154 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $80 | $112 | $175 |
| Interactive complexity add-on CPT 90785 • Mental Health | $13 | $15 | $17 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $113 | $135 | $162 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $179 | $191 | $196 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $57 | $70 | $79 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $52 | $67 | $81 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $85 | $97 | $105 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $66 | $86 | $103 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $98 | $127 | $158 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $78 | $106 | $124 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $106 | $132 | $149 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $47 | $62 | $79 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $81 | $93 | $116 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $107 | $120 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $23 | $28 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $17 | $181 | $266 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $69 | $141 | $256 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $57 | $192 | $266 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $197 | $264 | $331 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $66 | $232 | $399 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $52 | $56 | $59 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $33 | $98 | $166 |
| EMG needle each extremity complete CPT 95886 • Neurology | $45 | $108 | $173 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $104 | $159 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $126 | $198 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $75 | $92 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $182 | $235 | $311 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $178 | $342 | $509 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $38 | $97 | $131 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $134 | $187 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $70 | $192 | $279 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $169 | $361 |
| Office visit established patient minimal CPT 99211 • Office Visits | $4 | $20 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $21 | $54 | $94 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $88 | $123 | $151 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $10 | $142 | $227 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $63 | $205 | $300 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $116 | $179 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $197 | $242 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $149 | $266 | $355 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $61 | $84 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $97 | $133 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $131 | $201 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $43 | $102 | $136 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $80 | $154 | $193 |
| Consultation office straightforward CPT 99241 • Office Visits | $52 | $52 | $52 |
| Consultation office low complexity CPT 99243 • Office Visits | $94 | $171 | $215 |
| Consultation office high complexity CPT 99245 • Office Visits | $89 | $261 | $356 |