| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $82 | $156 | $268 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $114 | $247 | $501 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $91 | $194 | $356 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $96 | $251 | $481 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $46 | $120 | $238 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $78 | $169 | $327 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $76 | $180 | $341 |
| Group psychotherapy CPT 90853 • Mental Health | $18 | $53 | $91 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $9 | $15 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $209 | $209 | $209 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $136 | $242 | $453 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $451 | $451 | $451 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $189 | $288 | $387 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $407 | $933 | $1,459 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $105 | $137 | $169 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $152 | $191 | $271 |
| EMG needle each extremity complete CPT 95886 • Neurology | $86 | $119 | $152 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $299 | $299 | $299 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $105 | $146 | $220 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $73 | $168 | $264 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $586 | $586 | $586 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $262 | $442 | $622 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $56 | $120 | $164 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $103 | $170 | $218 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $169 | $263 | $378 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $225 | $324 | $432 |
| Office visit established patient minimal CPT 99211 • Office Visits | $23 | $38 | $46 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $52 | $78 | $109 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $52 | $137 | $182 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $110 | $136 | $198 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $158 | $291 | $362 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $65 | $180 | $285 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $198 | $293 | $384 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $166 | $337 | $566 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $75 | $99 | $113 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $68 | $151 | $203 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $144 | $236 | $292 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $154 | $203 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $117 | $213 | $300 |
| Consultation office low complexity CPT 99243 • Office Visits | $63 | $128 | $259 |
| Consultation office high complexity CPT 99245 • Office Visits | $246 | $451 | $624 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $758 | $1,415 | $2,071 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $129 | $129 | $129 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,269 | $2,586 | $3,904 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $368 | $525 | $681 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $3,615 | $3,615 | $3,615 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $546 | $1,108 | $1,669 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $296 | $643 | $991 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $747 | $1,606 | $2,465 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $508 | $1,154 | $1,800 |