| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $73 | $98 | $123 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $102 | $141 | $180 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $129 | $156 | $183 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $118 | $129 | $139 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $54 | $82 | $110 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $81 | $92 | $103 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $107 | $110 | $113 |
| Group psychotherapy CPT 90853 • Mental Health | $42 | $47 | $51 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $104 | $161 | $217 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $156 | $199 | $243 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $176 | $191 | $206 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $330 | $422 | $515 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $305 | $337 | $368 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $64 | $87 | $103 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $127 | $154 | $167 |
| EMG needle each extremity complete CPT 95886 • Neurology | $79 | $88 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $42 | $74 | $106 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $23 | $84 | $130 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $93 | $93 | $93 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $68 | $137 | $206 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $173 | $257 | $340 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $72 | $98 | $119 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $105 | $125 | $145 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $211 | $230 | $250 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $169 | $266 | $343 |
| Office visit established patient minimal CPT 99211 • Office Visits | $14 | $35 | $56 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $37 | $47 | $56 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $72 | $107 | $150 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $120 | $139 | $149 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $141 | $219 | $298 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $106 | $118 | $130 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $141 | $177 | $213 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $207 | $240 | $283 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $40 | $61 | $83 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $59 | $87 | $118 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $106 | $137 | $159 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $59 | $87 | $118 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $108 | $122 | $148 |
| Consultation office low complexity CPT 99243 • Office Visits | $114 | $150 | $185 |
| Consultation office high complexity CPT 99245 • Office Visits | $184 | $200 | $223 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $634 | $788 | $942 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $56 | $63 | $69 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,160 | $1,823 | $2,486 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $316 | $316 | $316 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $893 | $1,046 | $1,198 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $623 | $692 | $829 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $386 | $386 | $386 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $957 | $957 | $957 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,146 | $1,146 | $1,146 |