| Psychotherapy 60 minutes CPT 90837 • Mental Health | $119 | $208 | $258 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $138 | $210 | $272 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $92 | $211 | $330 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $44 | $44 | $44 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $75 | $123 | $158 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $73 | $139 | $238 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $29 | $45 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $9 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $97 | $194 | $341 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $247 | $269 | $318 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $124 | $213 | $314 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $41 | $456 | $887 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $356 | $643 | $1,054 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $51 | $208 | $287 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $58 | $293 | $410 |
| EMG needle each extremity complete CPT 95886 • Neurology | $102 | $150 | $232 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $111 | $227 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $86 | $204 | $289 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $131 | $199 | $283 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $135 | $276 | $455 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $83 | $392 | $718 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $94 | $115 | $143 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $80 | $145 | $201 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $93 | $246 | $381 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $115 | $290 | $480 |
| Office visit established patient minimal CPT 99211 • Office Visits | $5 | $24 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $20 | $54 | $86 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $45 | $83 | $140 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $134 | $198 | $253 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $138 | $175 | $206 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $49 | $121 | $187 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $77 | $116 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $252 | $342 | $463 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $59 | $72 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $53 | $82 | $101 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $130 | $155 | $191 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $91 | $109 | $135 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $71 | $162 | $246 |
| Consultation office low complexity CPT 99243 • Office Visits | $120 | $175 | $230 |
| Consultation office high complexity CPT 99245 • Office Visits | $238 | $308 | $418 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $921 | $921 | $921 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $28 | $28 | $28 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $728 | $1,101 | $1,474 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $126 | $126 | $126 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $691 | $691 | $691 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $330 | $330 | $330 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $293 | $365 | $437 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $463 | $726 | $988 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $785 | $790 | $794 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $55 | $122 | $190 |