| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $80 | $113 | $154 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $157 | $179 | $202 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $142 | $185 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $163 | $166 | $171 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $62 | $75 | $85 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $87 | $107 | $125 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $111 | $130 | $157 |
| Group psychotherapy CPT 90853 • Mental Health | $27 | $44 | $55 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $6 | $6 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $62 | $62 | $62 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $57 | $57 | $57 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $106 | $106 | $106 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $53 | $202 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $56 | $56 | $56 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $50 | $50 | $50 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $32 | $32 |
| EMG needle each extremity complete CPT 95886 • Neurology | $98 | $98 | $98 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $90 | $90 | $90 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $56 | $56 | $56 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $27 | $27 | $27 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $190 | $190 | $190 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $101 | $101 | $101 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $5 | $61 | $91 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $101 | $113 | $129 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $129 | $144 | $170 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $217 | $265 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $22 | $28 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $51 | $68 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $88 | $110 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $96 | $124 | $160 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $114 | $168 | $216 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $49 | $75 | $101 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $54 | $95 | $136 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $24 | $111 | $199 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $46 | $88 | $130 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $63 | $96 | $116 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $63 | $92 | $121 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $85 | $98 | $110 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $51 | $88 | $124 |
| Consultation office low complexity CPT 99243 • Office Visits | $17 | $69 | $122 |
| Consultation office high complexity CPT 99245 • Office Visits | $191 | $207 | $222 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $552 | $552 | $552 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $35 | $35 | $35 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $792 | $792 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $99 | $99 | $99 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $786 | $786 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $72 | $72 | $72 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $34 | $34 | $34 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $358 | $358 | $358 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $104 | $104 | $104 |