| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $87 | $97 | $115 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $138 | $169 | $185 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $119 | $136 | $145 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $132 | $142 | $150 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $69 | $74 | $81 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $117 | $127 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $113 | $126 | $150 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $57 | $77 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $3 | $5 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $108 | $170 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $17 | $78 | $139 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $106 | $124 | $133 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $143 | $310 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $426 | $428 | $430 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $61 | $101 | $130 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $80 | $141 | $183 |
| EMG needle each extremity complete CPT 95886 • Neurology | $47 | $66 | $97 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $38 | $77 | $103 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $22 | $64 | $111 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $67 | $77 | $88 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $88 | $127 | $175 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $57 | $182 | $285 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $53 | $67 | $79 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $30 | $74 | $109 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $30 | $111 | $163 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $30 | $126 | $221 |
| Office visit established patient minimal CPT 99211 • Office Visits | $3 | $12 | $22 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $46 | $53 | $57 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $10 | $58 | $88 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $96 | $112 | $125 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $149 | $151 | $155 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $110 | $150 | $171 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $30 | $116 | $170 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $149 | $189 | $219 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $6 | $59 | $129 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $78 | $106 | $129 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $113 | $124 | $130 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $79 | $112 | $130 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $15 | $87 | $129 |
| Consultation office low complexity CPT 99243 • Office Visits | $30 | $76 | $106 |
| Consultation office high complexity CPT 99245 • Office Visits | $184 | $215 | $254 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $53 | $434 | $646 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $5 | $39 | $73 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $848 | $1,060 | $1,271 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $178 | $248 | $318 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $786 | $1,038 | $1,282 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $482 | $550 | $685 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $113 | $218 | $314 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $107 | $480 | $852 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $30 | $248 | $685 |