| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $97 | $136 | $176 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $163 | $228 | $293 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $129 | $181 | $233 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $156 | $201 | $247 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $105 | $140 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $132 | $187 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $109 | $152 | $196 |
| Group psychotherapy CPT 90853 • Mental Health | $22 | $38 | $53 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $9 | $9 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $129 | $129 | $129 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $216 | $251 | $286 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $289 | $289 | $289 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $518 | $601 | $684 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $596 | $755 | $913 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $126 | $150 | $173 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $315 | $315 | $315 |
| EMG needle each extremity complete CPT 95886 • Neurology | $128 | $159 | $190 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $100 | $119 | $137 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $95 | $149 | $177 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $114 | $114 | $114 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $200 | $239 | $278 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $417 | $488 | $560 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $88 | $90 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $130 | $141 | $153 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $169 | $228 | $316 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $250 | $334 | $417 |
| Office visit established patient minimal CPT 99211 • Office Visits | $24 | $34 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $53 | $80 | $108 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $87 | $130 | $172 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $130 | $147 | $180 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $173 | $221 | $268 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $122 | $138 | $154 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $164 | $203 | $242 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $243 | $269 | $321 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $47 | $69 | $92 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $86 | $116 | $146 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $125 | $172 | $220 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $87 | $119 | $151 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $129 | $157 | $213 |
| Consultation office low complexity CPT 99243 • Office Visits | $114 | $142 | $163 |
| Consultation office high complexity CPT 99245 • Office Visits | $268 | $331 | $393 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,126 | $1,126 | $1,126 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $77 | $77 | $77 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,377 | $2,377 | $2,377 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $498 | $498 | $498 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $2,216 | $2,216 | $2,216 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,031 | $1,031 | $1,031 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $611 | $611 | $611 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,502 | $1,502 | $1,502 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,097 | $1,097 | $1,097 |