| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $90 | $94 | $98 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $99 | $125 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $132 | $144 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $144 | $160 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $82 | $95 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $111 | $130 | $150 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $116 | $133 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $52 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $86 | $246 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $126 | $129 | $132 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $132 | $132 | $132 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $183 | $247 | $312 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $364 | $364 | $364 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $111 | $120 | $130 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $81 | $141 | $183 |
| EMG needle each extremity complete CPT 95886 • Neurology | $97 | $97 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $58 | $58 | $58 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $41 | $59 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $134 | $145 | $157 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $117 | $117 | $117 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $204 | $204 | $204 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $20 | $88 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $83 | $147 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $139 | $156 | $176 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $168 | $191 | $221 |
| Office visit established patient minimal CPT 99211 • Office Visits | $10 | $27 | $52 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $76 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $77 | $123 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $106 | $119 | $129 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $120 | $233 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $136 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $189 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $161 | $257 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $42 | $59 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $73 | $105 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $103 | $150 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $75 | $106 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $106 | $148 | $238 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $111 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $32 | $258 | $499 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $646 | $646 | $646 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $58 | $58 | $58 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,130 | $1,200 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $233 | $297 | $360 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,282 | $1,282 | $1,282 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $483 | $584 | $685 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $252 | $252 | $252 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $852 | $852 | $852 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $461 | $573 | $685 |