| Psychotherapy 60 minutes CPT 90837 • Mental Health | $91 | $227 | $363 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $343 | $343 | $343 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $418 | $418 | $418 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $200 | $200 | $200 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $125 | $210 | $295 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $306 | $306 | $306 |
| Group psychotherapy CPT 90853 • Mental Health | $80 | $80 | $80 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $9 | $13 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $215 | $301 | $387 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $371 | $371 | $371 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $158 | $262 | $366 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $267 | $454 | $827 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $167 | $303 | $440 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $150 | $150 | $150 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $478 | $478 | $478 |
| EMG needle each extremity complete CPT 95886 • Neurology | $98 | $184 | $270 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $67 | $125 | $194 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $55 | $144 | $233 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $178 | $356 | $535 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $291 | $419 | $546 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $87 | $120 | $154 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $128 | $174 | $219 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $111 | $195 | $336 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $183 | $246 | $350 |
| Office visit established patient minimal CPT 99211 • Office Visits | $19 | $33 | $48 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $51 | $64 | $77 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $84 | $97 | $111 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $82 | $128 | $175 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $172 | $207 | $242 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $122 | $166 | $211 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $171 | $228 | $285 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $250 | $306 | $420 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $51 | $66 | $81 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $92 | $121 | $150 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $131 | $174 | $217 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $93 | $122 | $151 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $81 | $146 | $222 |
| Consultation office low complexity CPT 99243 • Office Visits | $97 | $156 | $201 |
| Consultation office high complexity CPT 99245 • Office Visits | $465 | $465 | $465 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $1,716 | $1,716 | $1,716 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $129 | $129 | $129 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $3,323 | $3,323 | $3,323 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $691 | $691 | $691 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $3,063 | $3,063 | $3,063 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $1,402 | $1,402 | $1,402 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $834 | $834 | $834 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $2,104 | $2,104 | $2,104 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,533 | $1,533 | $1,533 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $284 | $284 | $284 |