| Psychotherapy 60 minutes CPT 90837 • Mental Health | $113 | $145 | $176 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $162 | $162 | $162 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $248 | $248 | $248 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $128 | $128 | $128 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $119 | $119 | $119 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $152 | $152 | $152 |
| Group psychotherapy CPT 90853 • Mental Health | $42 | $42 | $42 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $6 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $203 | $203 | $203 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $194 | $194 | $194 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $169 | $169 | $169 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $75 | $75 | $75 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $362 | $362 | $362 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $47 | $47 | $47 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $110 | $110 | $110 |
| EMG needle each extremity complete CPT 95886 • Neurology | $70 | $70 | $70 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $77 | $77 | $77 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $116 | $116 | $116 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $275 | $275 | $275 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $66 | $70 | $73 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $99 | $131 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $167 | $200 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $205 | $218 | $252 |
| Office visit established patient minimal CPT 99211 • Office Visits | $9 | $20 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $43 | $50 | $53 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $71 | $83 | $89 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $30 | $88 | $119 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $145 | $162 | $177 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $88 | $104 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $141 | $168 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $204 | $249 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $42 | $43 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $58 | $78 | $90 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $100 | $110 | $128 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $74 | $75 | $75 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $108 | $109 |
| Consultation office low complexity CPT 99243 • Office Visits | $137 | $137 | $137 |
| Consultation office high complexity CPT 99245 • Office Visits | $248 | $248 | $248 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $879 | $879 | $879 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $69 | $69 | $69 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,458 | $1,458 | $1,458 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $328 | $422 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,476 | $1,476 | $1,476 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $777 | $777 | $777 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $559 | $559 | $559 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,338 | $1,338 | $1,338 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $461 | $712 | $962 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $103 | $184 | $264 |