| Psychotherapy 45 minutes CPT 90834 • Mental Health | $147 | $216 | $285 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $224 | $224 | $224 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $220 | $320 | $419 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $298 | $298 | $298 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $402 | $402 | $402 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $178 | $178 | $178 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $178 | $225 | $273 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $185 | $235 | $286 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $60 | $76 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $9 | $11 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $271 | $346 | $421 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $218 | $328 | $433 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $210 | $321 | $431 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $100 | $544 | $894 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $678 | $949 | $1,220 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $171 | $171 | $171 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $142 | $182 | $221 |
| EMG needle each extremity complete CPT 95886 • Neurology | $144 | $155 | $166 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $147 | $147 | $147 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $211 | $261 | $312 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $236 | $305 | $374 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $332 | $411 | $490 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $325 | $423 | $520 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $126 | $151 | $177 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $183 | $228 | $274 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $126 | $277 | $408 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $352 | $390 | $445 |
| Office visit established patient minimal CPT 99211 • Office Visits | $33 | $40 | $47 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $45 | $80 | $115 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $123 | $130 | $136 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $99 | $181 | $262 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $321 | $345 | $368 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $174 | $179 | $183 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $236 | $262 | $288 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $249 | $328 | $385 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $80 | $95 | $110 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $125 | $150 | $175 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $179 | $222 | $264 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $125 | $152 | $179 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $169 | $203 | $253 |
| Consultation office low complexity CPT 99243 • Office Visits | $197 | $197 | $197 |
| Consultation office high complexity CPT 99245 • Office Visits | $468 | $468 | $468 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,543 | $1,560 | $1,577 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $115 | $115 | $115 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,022 | $2,876 | $3,730 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $573 | $676 | $778 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $326 | $1,890 | $3,454 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,595 | $1,595 | $1,595 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $500 | $623 | $746 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,356 | $1,856 | $2,356 |