| Obstetric ultrasound limited CPT 76815 • Maternity | $48 | $67 | $88 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $34 | $50 | $70 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $11 | $15 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $115 | $141 | $159 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $122 | $160 | $209 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $48 | $61 | $79 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $41 | $64 | $74 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $79 | $100 | $112 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $63 | $70 | $83 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $115 | $128 | $155 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $95 | $107 | $124 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $112 | $146 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $71 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $75 | $80 | $85 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $90 | $105 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $25 | $30 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $48 | $98 | $147 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $136 | $149 | $162 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $12 | $61 | $110 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $262 | $299 | $337 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $91 | $276 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $64 | $78 | $91 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $33 | $92 | $166 |
| EMG needle each extremity complete CPT 95886 • Neurology | $37 | $42 | $46 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $71 | $92 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $63 | $89 | $114 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $28 | $42 | $57 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $124 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $109 | $128 | $147 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $52 | $64 | $71 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $48 | $87 | $112 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $86 | $136 | $218 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $116 | $166 | $205 |
| Office visit established patient minimal CPT 99211 • Office Visits | $5 | $15 | $21 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $23 | $40 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $58 | $62 | $67 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $62 | $106 | $181 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $91 | $121 | $168 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $11 | $57 | $95 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $128 | $147 | $169 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $196 | $222 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $75 | $112 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $57 | $76 | $112 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $97 | $104 | $112 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $52 | $64 | $72 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $98 | $100 | $103 |
| Consultation office straightforward CPT 99241 • Office Visits | $44 | $44 | $44 |
| Consultation office low complexity CPT 99243 • Office Visits | $91 | $103 | $116 |
| Consultation office high complexity CPT 99245 • Office Visits | $158 | $168 | $179 |