| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $77 | $111 | $138 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $120 | $130 | $149 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $135 | $158 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $122 | $144 | $167 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $59 | $60 | $60 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $85 | $110 | $132 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $88 | $111 | $132 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $51 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $45 | $142 | $196 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $21 | $69 | $145 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $115 | $165 | $230 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $65 | $223 | $323 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $265 | $370 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $72 | $96 | $107 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $30 | $87 | $151 |
| EMG needle each extremity complete CPT 95886 • Neurology | $16 | $47 | $79 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $87 | $95 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $21 | $63 | $103 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $57 | $65 | $70 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $76 | $111 | $168 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $130 | $218 | $267 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $28 | $67 | $92 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $8 | $84 | $130 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $12 | $76 | $175 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $42 | $152 | $250 |
| Office visit established patient minimal CPT 99211 • Office Visits | $1 | $16 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $49 | $53 | $55 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $77 | $82 | $90 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $42 | $66 | $98 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $76 | $133 | $174 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $109 | $128 | $148 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $51 | $121 | $164 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $216 | $232 | $240 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $29 | $62 | $115 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $56 | $96 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $42 | $80 | $123 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $27 | $73 | $115 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $77 | $110 | $127 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $98 | $149 |
| Consultation office high complexity CPT 99245 • Office Visits | $17 | $176 | $269 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $69 | $352 | $512 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $36 | $55 | $81 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,053 | $1,117 | $1,180 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $42 | $157 | $265 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $809 | $990 | $1,155 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $114 | $461 | $763 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $28 | $175 | $280 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $42 | $463 | $689 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $42 | $247 | $546 |