| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $58 | $78 | $98 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $101 | $132 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $118 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $283 | $433 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $70 | $71 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $150 | $223 | $295 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $89 | $119 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $26 | $42 | $58 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $14 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $123 | $132 | $141 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $135 | $135 | $135 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $371 | $371 | $371 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $44 | $205 | $366 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $115 | $630 | $1,144 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $60 | $198 | $337 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $89 | $99 |
| EMG needle each extremity complete CPT 95886 • Neurology | $41 | $69 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $41 | $47 | $52 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $50 | $50 | $50 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $60 | $60 | $60 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $193 | $212 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $162 | $162 | $162 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $40 | $72 | $122 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $136 | $216 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $167 | $365 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $121 | $245 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $16 | $22 | $31 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $32 | $62 | $111 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $31 | $63 | $90 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $97 | $249 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $80 | $196 | $353 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $76 | $129 | $183 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $98 | $100 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $128 | $137 | $147 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $63 | $100 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $129 | $149 | $175 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $78 | $137 | $204 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $54 | $111 | $134 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $162 | $252 |
| Consultation office low complexity CPT 99243 • Office Visits | $105 | $223 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $157 | $206 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,738 | $1,738 | $1,738 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $40 | $43 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $935 | $935 | $935 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $30 | $179 | $272 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $937 | $937 | $937 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,516 | $1,516 | $1,516 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $226 | $563 | $899 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $842 | $842 | $842 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $708 | $1,634 |