| Psychotherapy 30 minutes CPT 90832 • Mental Health | $85 | $96 | $123 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $74 | $95 | $127 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $93 | $115 | $163 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $92 | $119 | $161 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $136 | $180 | $247 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $113 | $157 | $213 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $181 | $219 | $258 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $66 | $88 | $123 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $112 | $147 | $198 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $103 | $145 | $206 |
| Group psychotherapy CPT 90853 • Mental Health | $50 | $60 | $69 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $6 | $8 | $10 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $30 | $166 | $303 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $150 | $199 | $248 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $147 | $191 | $236 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $383 | $478 | $666 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $111 | $281 | $451 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $101 | $119 | $128 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $95 | $148 | $183 |
| EMG needle each extremity complete CPT 95886 • Neurology | $83 | $92 | $100 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $101 | $142 | $184 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $131 | $131 | $132 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $280 | $280 | $280 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $206 | $289 | $371 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $321 | $441 | $561 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $75 | $100 | $126 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $138 | $160 | $183 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $132 | $194 | $279 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $180 | $251 | $304 |
| Office visit established patient minimal CPT 99211 • Office Visits | $22 | $31 | $38 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $44 | $55 | $65 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $95 | $108 | $123 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $106 | $147 | $182 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $185 | $226 | $303 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $100 | $133 | $174 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $135 | $190 | $235 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $199 | $243 | $348 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $38 | $60 | $75 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $71 | $102 | $124 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $102 | $142 | $179 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $72 | $102 | $125 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $105 | $136 | $184 |
| Consultation office low complexity CPT 99243 • Office Visits | $67 | $131 | $211 |
| Consultation office high complexity CPT 99245 • Office Visits | $209 | $267 | $384 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $30 | $591 | $1,151 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $30 | $64 | $131 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $2,263 | $2,263 | $2,263 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $642 | $642 | $642 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $30 | $1,157 | $2,283 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $554 | $776 | $1,220 |