| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $154 | $198 | $242 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $166 | $356 | $549 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $112 | $155 | $198 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $212 | $370 | $529 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $60 | $145 | $230 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $258 | $305 | $351 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $125 | $166 | $198 |
| Group psychotherapy CPT 90853 • Mental Health | $29 | $47 | $66 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $96 | $143 | $183 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $42 | $214 | $415 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $181 | $194 | $207 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $90 | $233 | $501 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $602 | $984 | $1,367 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $97 | $137 | $156 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $171 | $207 | $226 |
| EMG needle each extremity complete CPT 95886 • Neurology | $86 | $120 | $141 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $123 | $125 | $127 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $126 | $146 | $157 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $151 | $229 | $336 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $242 | $243 | $245 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $352 | $371 | $395 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $109 | $127 | $161 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $157 | $235 | $388 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $42 | $243 | $582 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $42 | $213 | $386 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $49 | $81 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $111 | $196 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $118 | $206 | $317 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $107 | $214 | $446 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $220 | $330 | $494 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $100 | $164 | $201 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $113 | $171 | $201 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $165 | $235 | $302 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $64 | $119 | $168 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $112 | $125 | $139 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $150 | $177 | $200 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $60 | $96 | $128 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $120 | $162 | $205 |
| Consultation office low complexity CPT 99243 • Office Visits | $42 | $162 | $237 |
| Consultation office high complexity CPT 99245 • Office Visits | $185 | $220 | $238 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $885 | $1,513 | $2,141 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $60 | $96 | $131 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,219 | $2,582 | $2,944 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $399 | $399 | $399 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $849 | $1,268 | $1,687 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $784 | $845 | $968 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $42 | $528 | $1,014 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $42 | $311 | $581 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,356 | $1,607 | $1,857 |