| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $119 | $173 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $139 | $161 | $184 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $108 | $124 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $150 | $213 | $276 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $61 | $71 | $82 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $150 | $170 | $210 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $150 | $176 | $220 |
| Group psychotherapy CPT 90853 • Mental Health | $50 | $51 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $132 | $270 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $30 | $94 | $139 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $133 | $184 | $285 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $63 | $257 | $581 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $63 | $246 | $429 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $154 | $240 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $179 | $344 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $107 | $129 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $52 | $66 | $89 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $59 | $90 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $162 | $183 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $169 | $264 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $285 | $395 | $616 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $71 | $80 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $114 | $124 | $142 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $81 | $152 | $215 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $189 | $249 | $338 |
| Office visit established patient minimal CPT 99211 • Office Visits | $2 | $23 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $28 | $54 | $78 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $89 | $124 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $19 | $116 | $175 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $223 | $276 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $30 | $97 | $147 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $173 | $181 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $193 | $224 | $241 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $72 | $111 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $30 | $80 | $111 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $15 | $111 | $164 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $73 | $111 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $102 | $137 | $158 |
| Consultation office low complexity CPT 99243 • Office Visits | $9 | $94 | $156 |
| Consultation office high complexity CPT 99245 • Office Visits | $217 | $248 | $285 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $601 | $880 | $1,160 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $52 | $82 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,271 | $1,271 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $515 | $515 | $515 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $786 | $1,282 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $673 | $1,055 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $252 | $252 | $252 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,558 | $1,558 | $1,558 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $104 | $395 | $685 |