| Psychotherapy 60 minutes CPT 90837 • Mental Health | $128 | $128 | $128 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $125 | $125 | $125 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $186 | $186 | $186 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $96 | $96 | $96 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $85 | $85 | $85 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $108 | $108 | $108 |
| Group psychotherapy CPT 90853 • Mental Health | $31 | $31 | $31 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $5 | $5 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $150 | $150 | $150 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $147 | $147 | $147 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $128 | $128 | $128 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $54 | $54 | $54 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $210 | $210 | $210 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $34 | $34 | $34 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $114 | $114 | $114 |
| EMG needle each extremity complete CPT 95886 • Neurology | $43 | $43 | $43 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $46 | $46 | $46 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $74 | $74 | $74 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $155 | $155 | $155 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $118 | $118 | $118 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $210 | $210 | $210 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $62 | $62 | $62 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $36 | $63 | $91 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $36 | $124 | $196 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $36 | $133 | $220 |
| Office visit established patient minimal CPT 99211 • Office Visits | $20 | $28 | $36 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $36 | $37 | $37 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $36 | $48 | $60 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $36 | $84 | $150 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $36 | $79 | $122 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $87 | $87 | $87 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $119 | $119 | $119 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $175 | $175 | $175 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $36 | $36 | $36 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $65 | $65 | $65 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $93 | $93 | $93 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $66 | $66 | $66 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $94 | $94 | $94 |
| Consultation office low complexity CPT 99243 • Office Visits | $94 | $94 | $94 |
| Consultation office high complexity CPT 99245 • Office Visits | $222 | $222 | $222 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $530 | $530 | $530 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $59 | $59 | $59 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,057 | $1,057 | $1,057 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $248 | $248 | $248 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $967 | $967 | $967 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $514 | $514 | $514 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $373 | $373 | $373 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $886 | $886 | $886 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $630 | $630 | $630 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $182 | $182 | $182 |