| Psychotherapy 60 minutes CPT 90837 • Mental Health | $144 | $175 | $227 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $99 | $129 | $151 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $218 | $218 | $218 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $133 | $133 | $133 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $76 | $90 | $104 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $110 | $130 | $151 |
| Group psychotherapy CPT 90853 • Mental Health | $38 | $45 | $54 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $7 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $136 | $216 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $181 | $185 | $188 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $138 | $211 | $277 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $76 | $213 | $377 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $80 | $347 | $519 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $78 | $104 | $117 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $87 | $149 | $191 |
| EMG needle each extremity complete CPT 95886 • Neurology | $66 | $99 | $129 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $44 | $44 | $44 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $47 | $80 | $118 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $64 | $115 | $197 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $143 | $196 | $259 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $303 | $416 | $532 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $65 | $88 | $100 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $77 | $102 | $145 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $177 | $229 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $234 | $288 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $27 | $32 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $35 | $45 | $61 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $61 | $96 | $126 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $55 | $108 | $150 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $153 | $172 | $202 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $106 | $141 | $175 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $106 | $149 | $185 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $55 | $201 | $283 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $32 | $65 | $96 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $88 | $99 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $117 | $129 | $149 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $58 | $74 | $98 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $138 | $187 |
| Consultation office low complexity CPT 99243 • Office Visits | $138 | $162 | $202 |
| Consultation office high complexity CPT 99245 • Office Visits | $201 | $213 | $225 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $596 | $609 | $622 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $46 | $52 | $55 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,705 | $1,705 | $1,705 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $288 | $288 | $288 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,708 | $1,708 | $1,708 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $588 | $588 | $588 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $655 | $655 | $655 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,535 | $1,535 | $1,535 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $55 | $475 | $729 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $247 | $247 | $247 |