| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $78 | $100 | $121 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $96 | $157 | $201 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $115 | $155 | $195 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $140 | $216 | $292 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $99 | $151 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $95 | $115 | $134 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $99 | $130 | $161 |
| Group psychotherapy CPT 90853 • Mental Health | $19 | $34 | $48 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $9 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $37 | $136 | $235 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $218 | $225 | $231 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $147 | $162 | $178 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $91 | $239 | $383 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $246 | $496 | $790 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $128 | $129 | $131 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $37 | $133 | $183 |
| EMG needle each extremity complete CPT 95886 • Neurology | $85 | $117 | $166 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $92 | $97 | $101 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $131 | $156 | $204 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $86 | $154 | $236 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $206 | $264 | $321 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $321 | $450 | $529 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $75 | $93 | $106 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $106 | $143 | $181 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $108 | $162 | $219 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $166 | $293 | $372 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $18 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $62 | $84 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $67 | $77 | $91 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $99 | $153 | $214 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $143 | $219 | $321 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $100 | $116 | $136 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $135 | $173 | $197 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $199 | $237 | $275 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $56 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $71 | $100 | $128 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $102 | $147 | $192 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $102 | $131 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $105 | $152 | $186 |
| Consultation office low complexity CPT 99243 • Office Visits | $115 | $131 | $147 |
| Consultation office high complexity CPT 99245 • Office Visits | $18 | $192 | $349 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $37 | $474 | $911 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $37 | $65 | $92 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,020 | $1,340 | $1,661 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $449 | $449 | $449 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $37 | $778 | $1,520 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $554 | $639 | $808 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $524 | $524 | $524 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,392 | $1,392 | $1,392 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $991 | $991 | $991 |