| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $46 | $51 | $56 |
| Interactive complexity add-on CPT 90785 • Mental Health | $14 | $26 | $39 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $130 | $139 | $149 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $140 | $157 | $175 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $63 | $86 | $109 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $64 | $115 | $166 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $84 | $114 | $145 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $83 | $113 | $143 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $125 | $126 | $127 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $109 | $205 | $301 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $131 | $131 | $131 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $62 | $62 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $101 | $106 | $110 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $105 | $105 | $105 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $47 | $70 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $8 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $154 | $306 | $459 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $127 | $236 | $344 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $121 | $253 | $384 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $343 | $473 | $603 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $155 | $274 | $392 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $117 | $117 | $117 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $165 | $165 | $165 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $100 | $154 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $53 | $53 | $53 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $60 | $87 | $114 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $138 | $139 | $139 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $80 | $161 | $242 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $288 | $549 | $811 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $49 | $111 | $172 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $104 | $179 | $254 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $123 | $205 | $331 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $200 | $256 | $365 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $52 | $94 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $25 | $60 | $94 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $70 | $105 | $140 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $100 | $101 | $104 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $140 | $236 | $331 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $99 | $222 | $345 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $134 | $239 | $345 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $198 | $252 | $349 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $39 | $96 | $153 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $71 | $112 | $153 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $102 | $140 | $179 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $71 | $112 | $153 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $105 | $143 | $184 |
| Consultation office straightforward CPT 99241 • Office Visits | $46 | $46 | $46 |
| Consultation office low complexity CPT 99243 • Office Visits | $119 | $194 | $269 |
| Consultation office high complexity CPT 99245 • Office Visits | $218 | $300 | $381 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $528 | $1,147 | $1,765 |