| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $66 | $207 | $347 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $98 | $180 | $225 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $105 | $110 | $116 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $142 | $359 | $576 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $52 | $76 | $100 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $82 | $90 | $98 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $101 | $130 | $158 |
| Group psychotherapy CPT 90853 • Mental Health | $20 | $30 | $40 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $270 | $657 | $1,044 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $192 | $382 | $762 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $188 | $189 | $190 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $296 | $611 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $292 | $721 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $65 | $117 | $152 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $187 | $368 | $729 |
| EMG needle each extremity complete CPT 95886 • Neurology | $94 | $126 | $151 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $122 | $174 | $227 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $67 | $119 | $152 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $56 | $197 | $289 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $106 | $209 | $281 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $295 | $402 | $518 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $74 | $115 | $129 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $118 | $149 | $180 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $59 | $197 | $309 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $166 | $254 | $325 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $30 | $35 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $71 | $113 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $98 | $131 | $176 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $97 | $119 | $154 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $158 | $217 | $268 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $109 | $133 | $164 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $159 | $210 | $258 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $196 | $218 | $231 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $71 | $112 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $70 | $96 | $112 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $112 | $171 | $252 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $81 | $107 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $136 | $170 | $226 |
| Consultation office low complexity CPT 99243 • Office Visits | $97 | $141 | $185 |
| Consultation office high complexity CPT 99245 • Office Visits | $206 | $246 | $291 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $943 | $1,668 | $2,392 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $13 | $42 | $68 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,331 | $2,331 | $2,331 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $405 | $405 | $405 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,630 | $1,767 | $1,903 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $747 | $837 | $886 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $291 | $406 | $521 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,056 | $1,056 | $1,056 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $530 | $530 | $530 |