| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $198 | $238 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $66 | $82 | $114 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $87 | $113 | $166 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $103 | $132 | $173 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $47 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $6 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $26 | $136 | $246 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $10 | $162 | $268 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $17 | $127 | $237 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $95 | $196 | $297 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $70 | $343 | $616 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $44 | $78 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $128 | $180 | $284 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $64 | $84 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $69 | $71 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $50 | $125 | $200 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $53 | $196 | $295 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $138 | $227 | $316 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $112 | $213 | $314 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $82 | $107 | $133 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $9 | $71 | $133 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $231 | $333 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $167 | $316 | $418 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $8 | $16 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $3 | $41 | $79 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $8 | $82 | $148 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $105 | $120 | $138 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $59 | $157 | $255 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $80 | $129 | $179 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $111 | $176 | $241 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $16 | $185 | $354 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $5 | $37 | $69 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $9 | $68 | $127 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $95 | $139 | $182 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $69 | $98 | $128 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $42 | $115 | $187 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $102 | $217 |
| Consultation office high complexity CPT 99245 • Office Visits | $18 | $207 | $395 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $239 | $661 | $1,082 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $8 | $44 | $81 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $881 | $1,791 | $2,417 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $186 | $347 | $491 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $821 | $1,370 | $1,919 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $507 | $695 | $883 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $47 | $393 | $604 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $744 | $934 | $1,315 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $407 | $683 | $958 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $114 | $135 | $177 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $237 | $1,169 | $2,101 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $104 | $506 | $909 |