| Obstetric ultrasound limited CPT 76815 • Maternity | $27 | $62 | $96 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $24 | $73 | $164 |
| Interactive complexity add-on CPT 90785 • Mental Health | $3 | $5 | $9 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $206 | $233 | $285 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $155 | $188 | $231 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $84 | $100 | $119 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $60 | $70 | $79 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $92 | $122 | $154 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $91 | $104 | $129 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $167 | $197 | $226 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $90 | $134 | $208 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $187 | $229 | $310 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $95 | $161 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $69 | $97 | $145 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $78 | $116 | $180 |
| Group psychotherapy CPT 90853 • Mental Health | $48 | $61 | $84 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $5 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $92 | $188 | $250 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $96 | $171 | $245 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $69 | $128 | $188 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $97 | $288 | $421 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $213 | $315 | $470 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $34 | $87 | $139 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $65 | $98 | $130 |
| EMG needle each extremity complete CPT 95886 • Neurology | $40 | $101 | $162 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $16 | $46 | $77 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $43 | $130 | $216 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $52 | $76 | $112 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $142 | $197 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $51 | $200 | $350 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $86 | $103 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $9 | $95 | $151 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $104 | $155 | $184 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $175 | $214 | $292 |
| Office visit established patient minimal CPT 99211 • Office Visits | $2 | $8 | $14 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $53 | $57 | $62 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $81 | $100 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $101 | $120 | $149 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $178 | $204 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $144 | $145 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $32 | $133 | $198 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $147 | $225 | $292 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $41 | $47 | $60 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $6 | $77 | $118 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $107 | $127 | $154 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $109 | $115 | $118 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $108 | $137 | $157 |
| Consultation office straightforward CPT 99241 • Office Visits | $53 | $53 | $53 |
| Consultation office low complexity CPT 99243 • Office Visits | $83 | $120 | $156 |
| Consultation office high complexity CPT 99245 • Office Visits | $175 | $273 | $370 |