| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $126 | $213 | $299 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $144 | $289 | $501 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $142 | $269 | $395 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $200 | $340 | $481 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $96 | $167 | $238 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $132 | $212 | $326 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $121 | $215 | $340 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $62 | $91 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $8 | $15 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $16 | $242 | $441 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $14 | $267 | $453 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $25 | $264 | $451 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $74 | $415 | $1,070 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $55 | $307 | $678 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $25 | $199 | $374 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $142 | $193 | $264 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $118 | $154 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $19 | $159 | $299 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $60 | $132 | $220 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $77 | $258 | $448 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $98 | $339 | $586 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $292 | $525 | $958 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $97 | $132 | $164 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $16 | $168 | $254 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $206 | $298 | $378 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $258 | $364 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $18 | $32 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $22 | $80 | $114 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $94 | $144 | $182 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $38 | $160 | $258 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $276 | $362 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $33 | $170 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $168 | $271 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $195 | $377 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $48 | $84 | $113 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $33 | $135 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $33 | $194 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $86 | $150 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $132 | $220 | $300 |
| Consultation office low complexity CPT 99243 • Office Visits | $180 | $260 | $341 |
| Consultation office high complexity CPT 99245 • Office Visits | $92 | $400 | $624 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $467 | $1,360 | $2,071 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $11 | $65 | $120 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,180 | $2,368 | $3,904 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $256 | $548 | $815 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $181 | $1,374 | $3,615 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $646 | $1,158 | $1,669 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $226 | $572 | $991 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $396 | $1,406 | $2,465 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $128 | $1,006 | $1,800 |