| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $69 | $88 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $123 | $140 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $92 | $123 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $137 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $72 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $107 | $128 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $109 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $30 | $53 | $78 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $0 | $2 | $3 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $30 | $30 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $23 | $23 | $23 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $79 | $79 | $79 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $311 | $311 | $311 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $374 | $376 | $379 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $111 | $111 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $121 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $49 | $49 | $49 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $18 | $18 | $18 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $65 | $65 | $65 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $67 | $67 | $67 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $175 | $175 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $143 | $143 | $143 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $60 | $66 | $70 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $82 | $96 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $124 | $169 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $156 | $210 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $16 | $30 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $27 | $49 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $30 | $74 | $91 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $82 | $104 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $14 | $123 | $176 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $59 | $116 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $20 | $109 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $124 | $174 | $198 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $30 | $62 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $62 | $91 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $93 | $108 | $129 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $30 | $78 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $93 | $113 | $143 |
| Consultation office low complexity CPT 99243 • Office Visits | $12 | $65 | $92 |
| Consultation office high complexity CPT 99245 • Office Visits | $21 | $96 | $172 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $301 | $529 | $758 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $30 | $30 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $792 | $792 | $792 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $197 | $283 | $368 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $210 | $210 | $210 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $48 | $48 | $48 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $30 | $163 | $296 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $501 | $582 | $663 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $104 | $306 | $508 |