| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $111 | $133 | $159 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $97 | $157 | $246 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $138 | $194 | $234 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $140 | $199 | $257 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $47 | $94 | $123 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $96 | $153 | $199 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $107 | $181 | $226 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $55 | $87 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $97 | $259 | $350 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $247 | $277 | $304 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $202 | $237 | $268 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $110 | $473 | $737 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $73 | $516 | $846 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $99 | $164 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $150 | $204 | $312 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $110 | $189 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $128 | $202 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $182 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $96 | $161 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $203 | $297 | $410 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $375 | $519 | $621 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $80 | $113 | $155 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $106 | $174 | $224 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $44 | $174 | $280 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $255 | $361 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $17 | $38 | $57 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $55 | $70 | $90 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $91 | $124 | $152 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $98 | $181 | $251 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $180 | $247 | $302 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $126 | $174 | $213 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $145 | $228 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $252 | $382 | $480 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $83 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $91 | $125 | $152 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $180 | $220 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $77 | $122 | $153 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $113 | $197 | $254 |
| Consultation office low complexity CPT 99243 • Office Visits | $120 | $155 | $225 |
| Consultation office high complexity CPT 99245 • Office Visits | $278 | $420 | $525 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,262 | $1,321 | $1,380 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $123 | $133 | $143 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,474 | $2,057 | $2,641 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $436 | $559 | $682 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,871 | $2,288 | $2,711 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $558 | $848 | $1,424 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $64 | $323 | $537 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $988 | $1,560 | $1,868 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $44 | $864 | $1,464 |