| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $123 | $136 | $149 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $74 | $79 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $99 | $116 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $97 | $108 | $120 |
| Group psychotherapy CPT 90853 • Mental Health | $23 | $27 | $31 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $12 | $139 | $266 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $34 | $129 | $225 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $118 | $164 | $209 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $66 | $130 | $194 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $214 | $342 | $470 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $18 | $46 | $73 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $26 | $61 | $96 |
| EMG needle each extremity complete CPT 95886 • Neurology | $52 | $53 | $53 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $45 | $55 | $66 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $77 | $103 | $129 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $72 | $117 | $161 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $89 | $97 | $105 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $101 | $158 | $216 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $6 | $47 | $89 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $133 | $166 | $199 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $227 | $262 | $296 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $195 | $361 |
| Office visit established patient minimal CPT 99211 • Office Visits | $40 | $40 | $41 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $16 | $47 | $78 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $27 | $58 | $90 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $175 | $181 | $188 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $198 | $253 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $104 | $179 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $81 | $161 | $242 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $198 | $277 | $355 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $69 | $79 | $89 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $69 | $98 | $127 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $30 | $107 | $183 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $59 | $93 | $128 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $43 | $115 | $188 |
| Consultation office low complexity CPT 99243 • Office Visits | $117 | $166 | $215 |
| Consultation office high complexity CPT 99245 • Office Visits | $144 | $269 | $394 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $100 | $576 | $1,052 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $10 | $49 | $88 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $763 | $1,519 | $2,274 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $207 | $340 | $473 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $164 | $1,131 | $2,098 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $58 | $510 | $962 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $378 | $475 | $572 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $147 | $794 | $1,440 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $106 | $577 | $1,049 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $79 | $134 | $190 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,038 | $1,671 | $2,304 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $96 | $544 | $992 |