| Obstetric ultrasound limited CPT 76815 • Maternity | $21 | $27 | $32 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $38 | $61 | $104 |
| Interactive complexity add-on CPT 90785 • Mental Health | $14 | $15 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $137 | $147 | $165 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $125 | $148 | $166 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $62 | $68 | $73 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $69 | $73 | $77 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $81 | $82 | $83 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $82 | $100 | $118 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $134 | $140 | $146 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $109 | $122 | $136 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $147 | $164 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $61 | $64 | $67 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $94 | $97 | $101 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $105 | $108 | $111 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $39 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $133 | $143 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $115 | $124 | $133 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $127 | $132 | $137 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $289 | $357 | $425 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $407 | $453 | $498 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $117 | $124 | $128 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $82 | $150 | $185 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $79 | $112 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $40 | $71 | $102 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $67 | $107 | $128 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $80 | $80 | $80 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $82 | $141 | $200 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $107 | $215 | $324 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $50 | $67 | $78 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $105 | $111 | $117 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $130 | $153 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $201 | $202 | $204 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $21 | $24 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $41 | $43 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $72 | $81 | $92 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $102 | $117 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $142 | $162 | $183 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $99 | $132 | $164 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $134 | $149 | $164 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $180 | $198 | $214 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $60 | $82 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $71 | $77 | $82 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $102 | $106 | $110 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $77 | $82 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $96 | $105 | $113 |
| Consultation office straightforward CPT 99241 • Office Visits | $32 | $32 | $32 |
| Consultation office low complexity CPT 99243 • Office Visits | $21 | $70 | $120 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $149 | $238 |