| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $93 | $135 | $181 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $27 | $67 | $141 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $31 | $99 | $190 |
| Interactive complexity add-on CPT 90785 • Mental Health | $10 | $26 | $37 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $143 | $182 | $262 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $119 | $190 | $341 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $53 | $82 | $117 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $40 | $43 | $47 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $82 | $117 | $200 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $88 | $90 | $92 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $119 | $147 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $78 | $91 | $104 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $106 | $134 | $161 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $53 | $110 | $167 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $95 | $126 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $100 | $177 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $38 | $63 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $7 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $22 | $106 | $204 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $20 | $170 | $320 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $18 | $165 | $318 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $262 | $284 | $322 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $66 | $175 | $440 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $47 | $56 | $64 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $56 | $111 | $166 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $126 | $228 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $19 | $64 | $109 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $46 | $92 | $163 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $81 | $132 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $74 | $116 | $178 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $291 | $433 | $717 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $8 | $107 | $160 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $122 | $161 | $216 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $94 | $224 | $348 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $140 | $228 | $374 |
| Office visit established patient minimal CPT 99211 • Office Visits | $12 | $28 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $40 | $60 | $94 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $60 | $115 | $176 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $10 | $104 | $249 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $274 | $353 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $69 | $160 | $218 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $152 | $217 | $295 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $281 | $385 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $26 | $63 | $116 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $28 | $104 | $155 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $104 | $204 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $6 | $82 | $121 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $72 | $135 | $210 |
| Consultation office straightforward CPT 99241 • Office Visits | $55 | $55 | $55 |
| Consultation office low complexity CPT 99243 • Office Visits | $81 | $125 | $171 |