| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $131 | $141 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $46 | $47 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $89 | $96 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $85 | $93 | $100 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $19 | $20 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $0 | $0 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $27 | $74 | $121 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $13 | $13 | $13 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $10 | $65 | $120 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $71 | $213 | $355 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $362 | $387 | $412 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $55 | $80 | $105 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $72 | $108 | $144 |
| EMG needle each extremity complete CPT 95886 • Neurology | $17 | $54 | $91 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $17 | $50 | $84 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $21 | $63 | $105 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $62 | $62 | $62 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $64 | $114 | $165 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $174 | $222 | $270 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $35 | $49 | $63 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $10 | $53 | $97 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $117 | $131 | $146 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $16 | $80 | $144 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $10 | $20 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $49 | $49 | $50 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $9 | $44 | $79 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $13 | $63 | $113 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $16 | $87 | $158 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $7 | $40 | $72 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $17 | $66 | $114 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $15 | $84 | $153 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $7 | $38 | $70 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $10 | $58 | $105 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $53 | $62 | $71 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $76 | $88 | $101 |
| Consultation office low complexity CPT 99243 • Office Visits | $71 | $81 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $101 | $150 | $200 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $260 | $420 | $580 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $3 | $20 | $36 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $771 | $771 | $771 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $19 | $19 | $19 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $763 | $888 | $1,013 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $330 | $399 | $468 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $33 | $33 | $33 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $104 | $104 | $104 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $355 | $355 | $355 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $11 | $11 | $11 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $166 | $633 | $1,100 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $239 | $359 | $478 |