| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $412 | $412 | $412 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $106 | $106 | $106 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $154 | $154 | $154 |
| EMG needle each extremity complete CPT 95886 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $85 | $85 | $85 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $107 | $107 | $107 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $168 | $168 | $168 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $272 | $272 | $272 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $66 | $66 | $66 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $58 | $83 | $108 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $107 | $122 | $131 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $128 | $180 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $23 | $23 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $45 | $46 | $47 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $75 | $80 | $85 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $110 | $113 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $148 | $166 | $184 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $71 | $71 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $113 | $113 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $16 | $72 | $128 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $43 | $43 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $58 | $58 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $93 | $93 | $93 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $75 | $75 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $108 | $110 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $81 | $131 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $126 | $230 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $534 | $534 | $534 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $38 | $38 | $38 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,140 | $1,140 | $1,140 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $233 | $233 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,056 | $1,056 | $1,056 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $486 | $486 | $487 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $323 | $424 | $526 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $103 | $103 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $499 | $499 | $499 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $329 | $329 | $329 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $466 | $466 | $466 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $779 | $779 | $779 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $63 | $63 | $63 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $75 | $75 | $75 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $133 | $133 | $133 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $113 | $113 | $113 |
| Visual field examination CPT 92083 • Ophthalmology | $54 | $54 | $54 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $25 | $30 | $35 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $26 | $34 | $43 |
| Fundus photography CPT 92250 • Ophthalmology | $24 | $24 | $24 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $47 | $47 | $47 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $48 | $48 | $48 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $42 | $45 | $48 |