| Psychotherapy 60 minutes CPT 90837 • Mental Health | $239 | $239 | $239 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $191 | $191 | $191 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $231 | $231 | $231 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $103 | $103 | $103 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $154 | $154 | $154 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $160 | $160 | $160 |
| Group psychotherapy CPT 90853 • Mental Health | $44 | $44 | $44 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $8 | $8 | $8 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $109 | $109 | $109 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $226 | $226 | $226 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $191 | $222 | $253 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $88 | $88 | $88 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $707 | $707 | $707 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $176 | $176 | $176 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $126 | $126 | $126 |
| EMG needle each extremity complete CPT 95886 • Neurology | $80 | $80 | $80 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $60 | $60 | $60 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $73 | $73 | $73 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $210 | $210 | $210 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $112 | $112 | $112 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $160 | $160 | $160 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $69 | $72 | $76 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $179 | $188 | $196 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $45 | $179 | $268 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $173 | $244 | $354 |
| Office visit established patient minimal CPT 99211 • Office Visits | $36 | $41 | $45 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $57 | $77 | $98 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $105 | $131 | $157 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $78 | $163 | $255 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $230 | $274 | $319 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $134 | $140 | $146 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $197 | $203 | $209 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $45 | $155 | $275 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $74 | $77 | $79 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $118 | $122 | $125 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $179 | $184 | $189 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $129 | $129 | $129 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $181 | $181 | $181 |
| Consultation office low complexity CPT 99243 • Office Visits | $139 | $139 | $139 |
| Consultation office high complexity CPT 99245 • Office Visits | $333 | $333 | $333 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $987 | $987 | $987 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $60 | $60 | $60 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $1,857 | $1,857 | $1,857 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $386 | $386 | $386 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,721 | $1,721 | $1,721 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $795 | $795 | $795 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $372 | $372 | $372 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $1,171 | $1,171 | $1,171 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $854 | $854 | $854 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $178 | $178 | $178 |