| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $58 | $103 | $145 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $97 | $124 | $157 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $83 | $159 | $263 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $101 | $138 | $176 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $44 | $57 | $71 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $72 | $129 | $179 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $74 | $164 | $254 |
| Group psychotherapy CPT 90853 • Mental Health | $17 | $40 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $3 | $4 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $83 | $198 | $407 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $92 | $171 | $257 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $89 | $200 | $294 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $73 | $433 | $827 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $40 | $355 | $950 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $78 | $181 | $284 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $32 | $82 | $161 |
| EMG needle each extremity complete CPT 95886 • Neurology | $63 | $131 | $212 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $37 | $101 | $227 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $80 | $204 | $292 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $40 | $153 | $254 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $51 | $272 | $460 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $131 | $428 | $698 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $35 | $95 | $165 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $72 | $153 | $255 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $90 | $208 | $384 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $64 | $236 | $484 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $35 | $55 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $30 | $67 | $128 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $50 | $118 | $207 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $73 | $128 | $251 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $77 | $223 | $412 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $71 | $144 | $228 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $96 | $183 | $307 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $140 | $298 | $451 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $27 | $52 | $88 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $50 | $107 | $162 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $72 | $154 | $233 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $50 | $107 | $163 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $73 | $175 | $254 |
| Consultation office low complexity CPT 99243 • Office Visits | $84 | $135 | $171 |
| Consultation office high complexity CPT 99245 • Office Visits | $154 | $364 | $525 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $419 | $918 | $1,417 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $29 | $95 | $160 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $911 | $1,172 | $1,474 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $44 | $102 | $160 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $835 | $1,756 | $2,564 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $380 | $431 | $483 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $225 | $297 | $369 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $575 | $1,115 | $1,781 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $419 | $789 | $1,154 |