| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $208 | $208 | $208 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $336 | $336 | $336 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $75 | $75 | $75 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $44 | $44 | $44 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $124 | $124 | $124 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $161 | $161 | $161 |
| Office visit established patient minimal CPT 99211 • Office Visits | $44 | $44 | $44 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $44 | $44 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $44 | $44 | $44 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $44 | $44 | $44 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $211 | $211 | $211 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $79 | $79 | $79 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $131 | $131 | $131 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $163 | $163 | $163 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $100 | $100 | $100 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $100 | $100 | $100 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $112 | $112 | $112 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $100 | $100 | $100 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $113 | $113 | $113 |
| Consultation office low complexity CPT 99243 • Office Visits | $123 | $123 | $123 |
| Consultation office high complexity CPT 99245 • Office Visits | $272 | $272 | $272 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $707 | $707 | $707 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $42 | $42 | $42 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,073 | $1,073 | $1,073 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $273 | $273 | $273 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $30 | $30 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $482 | $482 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $336 | $336 | $336 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $685 | $685 | $685 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $504 | $504 | $504 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $127 | $127 | $127 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $1,071 | $1,071 | $1,071 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $574 | $574 | $574 |
| Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology | $377 | $377 | $377 |
| Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology | $462 | $462 | $462 |
| Excision chalazion single CPT 67800 • Ophthalmology | $146 | $146 | $146 |
| Blepharoptosis repair levator resection CPT 67901 • Ophthalmology | $893 | $893 | $893 |
| Lacrimal punctum closure by plug CPT 68761 • Ophthalmology | $162 | $162 | $162 |
| Eye exam new patient intermediate CPT 92002 • Ophthalmology | $96 | $96 | $96 |
| Eye exam new patient comprehensive CPT 92004 • Ophthalmology | $83 | $83 | $83 |
| Eye exam established patient intermediate CPT 92012 • Ophthalmology | $102 | $102 | $102 |
| Eye exam established patient comprehensive CPT 92014 • Ophthalmology | $143 | $143 | $143 |
| Visual field examination CPT 92083 • Ophthalmology | $73 | $73 | $73 |
| Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology | $37 | $37 | $37 |
| Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology | $54 | $54 | $54 |
| Fundus photography CPT 92250 • Ophthalmology | $42 | $42 | $42 |
| Arthrocentesis aspiration small joint CPT 20600 • Orthopedics | $69 | $69 | $69 |
| Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics | $63 | $63 | $63 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $92 | $92 | $92 |
| Cervical spine fusion anterior approach CPT 22551 • Orthopedics | $1,640 | $1,640 | $1,640 |