| Psychotherapy 60 minutes CPT 90837 • Mental Health | $180 | $180 | $180 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $174 | $174 | $174 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $257 | $257 | $257 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $133 | $133 | $133 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $135 | $135 | $135 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $161 | $161 | $161 |
| Group psychotherapy CPT 90853 • Mental Health | $46 | $46 | $46 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $7 | $7 | $7 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $249 | $249 | $249 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $280 | $280 | $280 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $230 | $230 | $230 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $86 | $86 | $86 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $210 | $210 | $210 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $48 | $48 | $48 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $123 | $123 | $123 |
| EMG needle each extremity complete CPT 95886 • Neurology | $55 | $55 | $55 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $59 | $59 | $59 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $171 | $171 | $171 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $86 | $86 | $86 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $160 | $160 | $160 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $164 | $164 | $164 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $89 | $89 | $89 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $133 | $133 | $133 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $189 | $189 | $189 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $202 | $202 | $202 |
| Office visit established patient minimal CPT 99211 • Office Visits | $13 | $13 | $13 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $52 | $52 | $52 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $71 | $71 | $71 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $84 | $84 | $84 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $134 | $134 | $134 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $97 | $97 | $97 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $160 | $160 | $160 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $223 | $223 | $223 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $49 | $49 | $49 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $80 | $80 | $80 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $112 | $112 | $112 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $99 | $99 | $99 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $136 | $136 | $136 |
| Consultation office low complexity CPT 99243 • Office Visits | $134 | $134 | $134 |
| Consultation office high complexity CPT 99245 • Office Visits | $263 | $263 | $263 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $953 | $953 | $953 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $105 | $105 | $105 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,738 | $1,738 | $1,738 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $513 | $513 | $513 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,542 | $1,542 | $1,542 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $827 | $827 | $827 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $599 | $599 | $599 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,503 | $1,503 | $1,503 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $1,131 | $1,131 | $1,131 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $260 | $260 | $260 |