| Obstetric ultrasound limited CPT 76815 • Maternity | $163 | $170 | $177 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $82 | $159 | $211 |
| Interactive complexity add-on CPT 90785 • Mental Health | $5 | $19 | $33 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $154 | $225 | $364 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $162 | $249 | $408 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $78 | $110 | $168 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $87 | $118 | $172 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $97 | $148 | $224 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $98 | $165 | $233 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $157 | $246 | $335 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $144 | $215 | $286 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $176 | $274 | $371 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $95 | $137 | $178 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $179 | $246 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $202 | $255 |
| Group psychotherapy CPT 90853 • Mental Health | $58 | $62 | $67 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $85 | $186 | $244 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $132 | $219 | $341 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $195 | $286 | $377 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $153 | $343 | $565 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $429 | $756 | $1,082 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $168 | $281 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $161 | $256 | $445 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $145 | $244 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $73 | $95 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $111 | $115 | $123 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $169 | $169 | $169 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $104 | $207 | $261 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $389 | $501 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $100 | $118 | $147 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $148 | $154 | $157 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $164 | $213 | $278 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $197 | $329 |
| Office visit established patient minimal CPT 99211 • Office Visits | $29 | $36 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $63 | $74 | $87 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $106 | $114 | $127 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $125 | $143 | $167 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $211 | $221 | $235 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $100 | $149 | $198 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $169 | $222 | $295 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $288 | $434 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $58 | $66 | $77 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $103 | $117 | $142 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $154 | $170 | $203 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $101 | $121 | $156 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $158 | $229 |
| Consultation office straightforward CPT 99241 • Office Visits | $63 | $63 | $63 |
| Consultation office low complexity CPT 99243 • Office Visits | $127 | $162 | $188 |
| Consultation office high complexity CPT 99245 • Office Visits | $213 | $341 | $482 |