| Obstetric ultrasound limited CPT 76815 • Maternity | $50 | $60 | $71 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $32 | $66 | $84 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $5 | $5 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $146 | $167 | $191 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $122 | $168 | $191 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $48 | $70 | $92 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $40 | $71 | $102 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $73 | $91 | $110 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $66 | $91 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $116 | $127 | $138 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $126 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $159 | $168 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $71 | $77 | $83 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $74 | $93 | $112 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $121 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $52 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $61 | $61 | $61 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $104 | $118 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $97 | $97 | $97 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $132 | $132 | $132 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $46 | $46 | $46 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $42 | $77 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $98 | $140 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $46 | $46 | $46 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $50 | $50 | $50 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $35 | $48 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $65 | $76 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $74 | $74 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $289 | $289 | $289 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $37 | $53 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $57 | $83 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $96 | $164 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $123 | $167 | $216 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $23 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $19 | $38 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $52 | $70 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $109 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $105 | $140 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $74 | $122 | $170 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $102 | $136 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $150 | $182 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $31 | $80 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $55 | $92 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $79 | $104 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $56 | $93 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $81 | $105 | $130 |
| Consultation office straightforward CPT 99241 • Office Visits | $41 | $41 | $41 |
| Consultation office low complexity CPT 99243 • Office Visits | $80 | $126 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $190 | $223 | $255 |