| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $124 | $211 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $136 | $229 | $322 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $107 | $164 | $277 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $130 | $174 | $217 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $64 | $76 | $100 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $66 | $139 | $261 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $93 | $152 | $271 |
| Group psychotherapy CPT 90853 • Mental Health | $16 | $40 | $65 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $153 | $332 | $511 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $158 | $182 | $206 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $158 | $160 | $163 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $379 | $488 | $706 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $440 | $498 | $555 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $89 | $105 | $113 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $131 | $152 | $162 |
| EMG needle each extremity complete CPT 95886 • Neurology | $74 | $86 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $55 | $79 | $91 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $113 | $115 | $120 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $136 | $168 | $200 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $178 | $203 | $253 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $246 | $276 | $291 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $123 | $192 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $167 | $220 | $272 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $138 | $162 | $210 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $216 | $380 | $522 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $21 | $27 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $47 | $81 | $113 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $75 | $118 | $187 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $106 | $183 | $274 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $281 | $325 | $368 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $69 | $152 | $258 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $176 | $263 | $349 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $401 | $478 | $516 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $62 | $81 | $100 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $66 | $115 | $186 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $190 | $265 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $67 | $92 | $143 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $95 | $110 | $139 |
| Consultation office low complexity CPT 99243 • Office Visits | $123 | $157 | $191 |
| Consultation office high complexity CPT 99245 • Office Visits | $229 | $248 | $286 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $670 | $684 | $698 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $48 | $68 | $89 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,467 | $1,664 | $1,860 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $268 | $268 | $268 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,356 | $2,222 | $3,954 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $625 | $692 | $824 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $970 | $970 | $970 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $926 | $974 | $1,022 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $676 | $1,406 | $2,135 |