| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $154 | $243 | $308 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $30 | $48 | $71 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $179 | $292 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $19 | $42 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $143 | $181 | $227 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $160 | $199 | $254 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $70 | $91 | $111 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $71 | $97 | $114 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $92 | $119 | $147 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $98 | $146 | $224 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $138 | $166 | $220 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $129 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $276 | $402 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $87 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $111 | $147 | $178 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $192 | $285 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $46 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $8 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $272 | $421 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $93 | $139 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $227 | $431 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $132 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $100 | $297 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $73 | $99 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $142 | $171 | $221 |
| EMG needle each extremity complete CPT 95886 • Neurology | $80 | $91 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $131 | $250 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $146 | $312 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $88 | $157 | $250 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $293 | $490 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $280 | $294 | $325 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $97 | $126 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $174 | $187 | $203 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $247 | $408 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $90 | $206 | $352 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $29 | $47 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $55 | $83 | $115 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $87 | $142 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $19 | $132 | $201 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $247 | $299 | $368 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $129 | $183 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $203 | $242 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $198 | $300 | $385 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $67 | $85 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $113 | $175 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $127 | $185 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $115 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $110 | $182 | $253 |
| Consultation office straightforward CPT 99241 • Office Visits | $52 | $52 | $52 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $109 | $251 |