| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $151 | $181 | $215 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $75 | $106 | $129 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $117 | $164 | $209 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $91 | $128 | $173 |
| Group psychotherapy CPT 90853 • Mental Health | $45 | $50 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $4 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $52 | $149 | $246 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $59 | $188 | $268 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $23 | $109 | $195 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $59 | $77 | $95 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $174 | $443 | $712 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $88 | $143 | $198 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $26 | $146 | $284 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $64 | $84 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $68 | $69 | $71 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $88 | $100 | $112 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $60 | $83 | $106 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $69 | $103 | $136 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $224 | $269 | $314 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $30 | $59 | $89 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $9 | $99 | $188 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $54 | $182 | $263 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $298 | $418 |
| Office visit established patient minimal CPT 99211 • Office Visits | $2 | $21 | $40 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $7 | $43 | $79 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $37 | $105 | $148 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $79 | $129 | $190 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $133 | $194 | $255 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $80 | $129 | $179 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $54 | $148 | $241 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $79 | $217 | $354 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $69 | $81 | $92 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $95 | $111 | $127 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $8 | $95 | $182 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $6 | $67 | $128 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $42 | $115 | $187 |
| Consultation office low complexity CPT 99243 • Office Visits | $121 | $169 | $217 |
| Consultation office high complexity CPT 99245 • Office Visits | $61 | $200 | $338 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $72 | $518 | $964 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $6 | $35 | $65 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $822 | $1,448 | $2,075 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $186 | $370 | $491 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $821 | $1,370 | $1,919 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $507 | $695 | $883 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $36 | $348 | $527 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $558 | $937 | $1,315 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $543 | $751 | $958 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $46 | $142 | $208 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $237 | $1,169 | $2,101 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $50 | $479 | $909 |