| Psychotherapy 60 minutes CPT 90837 • Mental Health | $224 | $224 | $224 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $195 | $195 | $195 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $235 | $235 | $235 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $112 | $112 | $112 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $182 | $182 | $182 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $189 | $189 | $189 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $45 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $10 | $10 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $282 | $282 | $282 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $237 | $237 | $237 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $237 | $237 | $237 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $525 | $525 | $525 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $104 | $104 | $104 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $122 | $122 | $122 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $149 | $149 | $149 |
| EMG needle each extremity complete CPT 95886 • Neurology | $160 | $160 | $160 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $172 | $172 | $172 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $221 | $221 | $221 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $347 | $347 | $347 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $526 | $526 | $526 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $91 | $91 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $138 | $138 | $138 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $233 | $233 | $233 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $368 | $368 | $368 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $16 | $16 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $77 | $77 | $77 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $129 | $129 | $129 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $190 | $190 | $190 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $256 | $256 | $256 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $183 | $183 | $183 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $245 | $245 | $245 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $363 | $363 | $363 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $70 | $70 | $70 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $129 | $129 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $187 | $187 | $187 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $129 | $129 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $191 | $191 | $191 |
| Consultation office low complexity CPT 99243 • Office Visits | $216 | $216 | $216 |
| Consultation office high complexity CPT 99245 • Office Visits | $395 | $395 | $395 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,075 | $1,075 | $1,075 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $121 | $121 | $121 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,107 | $2,107 | $2,107 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $433 | $433 | $433 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,940 | $1,940 | $1,940 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,139 | $1,139 | $1,139 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $521 | $521 | $521 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,413 | $1,413 | $1,413 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,136 | $1,136 | $1,136 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $181 | $181 | $181 |