| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $104 | $131 | $160 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $109 | $161 | $246 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $114 | $183 | $263 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $177 | $217 | $257 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $66 | $94 | $123 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $137 | $190 | $245 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $107 | $188 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $24 | $45 | $61 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $97 | $272 | $368 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $164 | $230 | $269 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $202 | $245 | $294 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $53 | $346 | $536 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $110 | $526 | $950 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $99 | $191 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $76 | $139 | $183 |
| EMG needle each extremity complete CPT 95886 • Neurology | $59 | $120 | $212 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $159 | $227 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $158 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $102 | $155 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $136 | $269 | $460 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $361 | $486 | $698 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $80 | $128 | $174 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $133 | $192 | $252 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $161 | $198 | $237 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $255 | $398 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $28 | $46 | $64 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $64 | $101 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $91 | $129 | $171 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $10 | $87 | $193 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $138 | $245 | $339 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $107 | $176 | $239 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $170 | $248 | $324 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $55 | $289 | $480 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $86 | $146 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $91 | $130 | $171 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $186 | $247 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $91 | $130 | $171 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $133 | $192 | $254 |
| Consultation office low complexity CPT 99243 • Office Visits | $129 | $148 | $178 |
| Consultation office high complexity CPT 99245 • Office Visits | $64 | $319 | $525 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,380 | $1,399 | $1,417 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $123 | $142 | $160 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,474 | $2,300 | $2,785 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $615 | $691 | $767 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,871 | $2,382 | $2,711 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $658 | $1,041 | $1,424 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $293 | $561 | $725 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $988 | $1,531 | $1,825 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $794 | $1,138 | $1,464 |