| Psychotherapy 60 minutes CPT 90837 • Mental Health | $131 | $203 | $275 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $131 | $185 | $240 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $177 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $92 | $92 | $92 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $105 | $150 | $195 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $128 | $180 | $232 |
| Group psychotherapy CPT 90853 • Mental Health | $36 | $41 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $9 | $11 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $82 | $215 | $348 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $220 | $326 | $433 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $141 | $223 | $304 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $67 | $428 | $788 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $123 | $525 | $927 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $157 | $265 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $133 | $133 | $133 |
| EMG needle each extremity complete CPT 95886 • Neurology | $114 | $160 | $206 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $64 | $137 | $209 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $72 | $171 | $271 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $96 | $205 | $314 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $240 | $332 | $424 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $163 | $412 | $662 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $74 | $118 | $161 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $110 | $172 | $233 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $155 | $176 | $196 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $196 | $351 | $506 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $28 | $46 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $45 | $69 | $94 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $60 | $109 | $158 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $94 | $178 | $262 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $104 | $209 | $313 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $75 | $147 | $220 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $124 | $210 | $297 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $172 | $306 | $440 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $37 | $61 | $85 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $61 | $109 | $156 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $87 | $156 | $226 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $78 | $118 | $157 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $107 | $170 | $233 |
| Consultation office low complexity CPT 99243 • Office Visits | $139 | $188 | $238 |
| Consultation office high complexity CPT 99245 • Office Visits | $251 | $340 | $430 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $670 | $1,035 | $1,400 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $80 | $115 | $149 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,282 | $2,832 | $4,381 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $368 | $384 | $400 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,192 | $2,379 | $3,566 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $638 | $1,501 | $2,363 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $477 | $674 | $870 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,129 | $2,033 | $2,937 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $849 | $1,604 | $2,359 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $256 | $316 | $377 |