| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $37 | $51 | $65 |
| Interactive complexity add-on CPT 90785 • Mental Health | $16 | $16 | $16 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $147 | $177 | $210 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $160 | $162 | $164 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $51 | $62 | $73 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $54 | $65 | $76 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $76 | $97 | $109 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $97 | $97 | $97 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $163 | $164 | $166 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $127 | $127 | $127 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $170 | $170 | $170 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $73 | $73 | $73 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $100 | $109 | $119 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $123 | $123 | $123 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $28 | $32 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $165 | $165 | $165 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $159 | $159 | $159 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $159 | $159 | $159 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $427 | $427 | $427 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $508 | $508 | $508 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $141 | $141 | $141 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $202 | $202 | $202 |
| EMG needle each extremity complete CPT 95886 • Neurology | $114 | $114 | $114 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $64 | $64 | $64 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $63 | $63 | $63 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $95 | $95 | $95 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $128 | $128 | $128 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $133 | $133 | $133 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $59 | $63 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $89 | $92 | $95 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $162 | $192 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $225 | $234 | $243 |
| Office visit established patient minimal CPT 99211 • Office Visits | $11 | $20 | $29 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $45 | $49 | $53 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $72 | $81 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $77 | $102 | $137 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $121 | $126 | $131 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $98 | $120 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $137 | $161 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $151 | $194 | $237 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $46 | $54 | $61 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $73 | $79 | $85 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $113 | $122 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $80 | $85 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $116 | $125 |
| Consultation office straightforward CPT 99241 • Office Visits | $42 | $42 | $42 |
| Consultation office low complexity CPT 99243 • Office Visits | $145 | $145 | $145 |
| Consultation office high complexity CPT 99245 • Office Visits | $264 | $264 | $264 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $645 | $645 | $645 |