| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $107 | $146 | $185 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $138 | $211 | $284 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $166 | $194 | $223 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $200 | $248 | $297 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $81 | $105 | $129 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $135 | $171 | $208 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $160 | $188 | $217 |
| Group psychotherapy CPT 90853 • Mental Health | $42 | $47 | $51 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $10 | $10 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $173 | $228 | $283 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $138 | $205 | $272 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $126 | $174 | $222 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $372 | $543 | $715 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $425 | $577 | $729 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $124 | $127 | $132 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $170 | $172 | $174 |
| EMG needle each extremity complete CPT 95886 • Neurology | $91 | $95 | $99 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $96 | $144 | $191 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $105 | $118 | $125 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $166 | $166 | $166 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $196 | $289 | $383 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $292 | $340 | $388 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $92 | $103 | $113 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $160 | $177 | $193 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $161 | $233 | $296 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $258 | $290 | $308 |
| Office visit established patient minimal CPT 99211 • Office Visits | $34 | $38 | $41 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $67 | $74 | $81 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $110 | $122 | $135 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $144 | $155 | $161 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $214 | $239 | $263 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $146 | $166 | $185 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $197 | $224 | $251 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $291 | $317 | $369 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $72 | $78 | $84 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $105 | $119 | $132 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $150 | $170 | $190 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $106 | $119 | $133 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $155 | $169 | $195 |
| Consultation office low complexity CPT 99243 • Office Visits | $180 | $202 | $224 |
| Consultation office high complexity CPT 99245 • Office Visits | $326 | $335 | $352 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $467 | $793 | $1,120 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $69 | $82 | $94 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,421 | $2,421 | $2,421 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $340 | $422 | $504 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,206 | $1,719 | $2,233 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $645 | $771 | $1,023 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $482 | $482 | $482 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,533 | $1,533 | $1,533 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,117 | $1,117 | $1,117 |